DSHS ESA CSD Public Benefits Specialist 4

Description

DSHS ESA CSD – Public Benefits Specialist 4, Lead Worker Specialized Medical Unit
Elevate your career in a lead role that truly makes a difference! The Economic Services Administration (ESA), Community Services Division, has an opportunity as a Public Benefit Specialist 4 (PBS4) to join our team at our Customer Service Contact Centers, Specialized Medical Unit.
 
As a Lead worker, you’re expected to possess a high level of proficiency in all public benefit programs, especially, all Medical programs. Responsible to audit, coach, train and guide lower-level Public Benefits Specialists. 
 
This position will have access to the Washington Health Plan Finder (HPF) system and personally identifiable information (PII). Per the Information Exchange Agreement No. 2013-02 between the Centers for Medicare & Medicaid Services (CMS) and State-Based Exchanges for the disclosure of health insurance affordability programs information under the Patient Protection and Affordable Care Act, passing a criminal background check is required for this position.
 
If you are an experienced professional ready to lead, mentor, and ensure the quality of public assistance services, this role offers the opportunity to make a lasting impact within the Community Services Division.

See why people like you chose careers with DSHS:


Some of what you'll do:

• Assigns work to Public Benefits Specialist staff who process cash, medical, and/or food benefits.
• Audits/reviews 100% of all cases that have met their Spenddown prior to approval. Conducts ongoing audits for new and experienced staff. Establishes reports and recommendations to supervisor on staff progress.
• Performs more complex duties in relation to establishing financial eligibility, rule interpretation, planning, and procedural development.
• Reviews cases and independently analyzes case actions for accuracy. Contacts staff, agencies and the community as necessary for clarifying information.
• Uses basic understanding of the administrative hearing process to review cases and to help decide if a hearing request can be settled prior to submission and assures appropriate action is taken.
• Assists customers with the process of applying for Apple Healthcare by entering information into the Health Plan Finder (HPF) system on behalf of the clients.
• Investigates and resolves customer complaints. Reviews and coordinates resolution of case errors. Identifies and reports performance gaps. Works independently or with others to identify and carry out creative solutions to performance issues.
• Obtain and review necessary data, documentation and verification for Federal or State assistance as it relates to the individual’s specific circumstance.

• Knowledgeable in Medical Eligibility as well as the Spenddown program and knowledge of Washington Administrative Code (WAC), policies, and procedures used to determine eligibility for Community Services Division programs.
• Proficiency using computer systems and applications to process cases, research information, and make accurate eligibility decisions.
• Ability to analyze and interpret complex data from multiple sources to ensure accurate and timely case actions.
• Strong interpersonal and customer service skills, with the ability to interact professionally and respectfully with clients, coworkers, and community partners.
• Ability to independently prioritize and manage a high-volume workload while meeting established deadlines.
• Resilience and professionalism when working in high-pressure situations and handling challenging customer interactions.
• Flexibility to adapt to changing priorities and effectively manage multiple assignments in a fast-paced environment while meeting performance expectations.

• Professionals with 12 months of experience as a Public Benefits Specialist 3. 

• A Bachelor’s degree or higher AND twelve months of experience as a Public Benefits Specialist 2 determining eligibility for public assistance or long-term care services.

• 5 years of combined higher education and/or equivalent experience may substitute for degree and PBS work experience requirements. Total must include at least one year’s equivalent work experience. Examples of equivalent experience include but are not limited to:
  • Providing eligibility for services or direct customer service serving historically marginalized communities
  • Experience examining/processing loan applications
  • Medical insurance or rehabilitation claims
  • Unemployment insurance claims
  • Providing staff support in financial eligibility determination, or in a job analyzing, verifying, and evaluating financial data and information

• Satisfactory completion of the agency’s Public Benefits Specialist Training Program.

• An updated resume
• Three professional references with contact information

Supplemental Information

Prior to a new hire, a background check including criminal record history may be conducted. Information from the background check will not necessarily preclude employment but will be considered in determining the applicant's suitability and competence to perform in the job. This announcement may be used to fill multiple vacancies. Employees driving on state business must have a valid driver's license. Employees driving a privately owned vehicle on state business must have liability insurance on the privately owned vehicle.
 
Washington State Department of Social and Health Services is an equal opportunity employer and does not discriminate in any area of employment, its programs or services on the basis of age, sex, sexual orientation, gender, gender identity/expression, marital status, race, creed, color, national origin, religion or beliefs, political affiliation, military status, honorably discharged veteran, Vietnam Era, recently separated or other protect­ed veteran status, the presence of any sensory, mental, physical disability or the use of a trained dog guide or service animal by a person with a disability, equal pay or genetic information. Persons requiring accommodation in the application process or this job announcement in an alternative format may contact the Recruiter at (360) 725-5810. Applicants who are deaf or hard of hearing may call through Washington Relay Service by dialing 7-1-1 or 1-800-833-6384.

 

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