Income Maintenance Caseworker II - Family and Children's Medicaid
Polk County Local Government
·2 days ago
- Salary
- $34k+/yr
- Location
- Columbus, NC, US
- Department
- Operations
- Education
- Associate
- Source
- GovernmentJobs
Description
General Statement of Duties
The primary purpose of the Economic Services Unit of the Polk County Health and Human Services Agency (HHSA) is to administer public assistance programs to adults, families and children in Polk County. The programs provide a safety net for individuals and families to meet their basic needs and include but are not limited to Work First, Medicaid and Food and Nutrition Services.
Distinguishing Features of the Position
The primary purpose of the Economic Services-Medicaid Unit of the Polk County HHSA is to administer public assistance programs to adults, families and children in Polk County. The programs provide a safety net for individuals and families to meet their basic needs and include but are not limited to Medicaid and Food and Nutrition Services.Duties and Responsibilities
Tasks include: intake, interviewing, program explanation, categorical determination, verification and investigative documentation, periodically reviewing each determination, referrals to agency and community resources.
The worker must meticulously monitor processing procedures to assure that the application is taken timely and processed without delays. This monitoring process assures compliance with federal and state regulations and county policies and it allows the client to be served in the most expedient and judicial manner possible.
Meeting deadlines are a daily part of the responsibilities. The IMC II must be continuously aware of time frames and the importance of exact and efficient scheduling and keep up with all deadlines and must utilize the various internal and state issued reports including but not limited to Case management and the Application Pending Reports on a daily basis. Office materials and workspace must be organized and case files readily available for review.
IMC II employees are expected to obtain and record sensitive information, compute eligibility and enter that data into the NC FAST system to issue applicant I client benefits accurately and timely. IMC II employees are to enter data into the state system, reconcile budgets and respond to data received from outside sources such as FRR and BEER reports.
The IMC II will make the final decision in the case. The Family and Children's Medicaid Lead Worker or Income Maintenance Supervisor second-party reviews all new applications, denials, withdrawals and inquiries plus all reviews for workers who have been employed less than one year or for workers who may be having difficulty implementing policy requirements. For workers who have been employed over one year, fifty (50%) of cases are pulled at random for review.
The IMC II will be involved in fraud cases to the extent necessary to compile the information to refer to the Program Integrity Worker for investigation and as supportive to the case in establishing evidence leading to suspected fraud. The IMC II would be required to assist in the report to the DSS Board, the attorney, court officials and to testify in court should the case move to charges and trial for disposition of the case.
IMC II will take the initial application for the Family and Children's Medicaid Programs. Through the interview process the worker will complete all follow-up activities to verify required information and determine eligibility; process the information to approve or deny the application based on eligibility guidelines; maintain the case as necessary throughout the eligibility period and continue the process through reviews and changes that may occur at any point in the process.
In accordance with policy and procedure, the worker should complete the Medicaid application as soon as possible but no longer than the 45-day time frame for MIC, MAF, MPW, NCHC, Family Planning and Breast and Cervical Cancer. Within that 45-day time frame, the worker must send all mandated notices for any information needed to complete the application and should assist the applicant in any way possible to obtain the required verifications. Case decisions will be made and notices made in the timely manner as required by policy and procedure. Once all required verifications are received, action is to be taken within five (5) workdays to allow the client every possible benefit.
Other Duties As Assigned
Other duties will be assigned and may include but not be limited to participation in community outreach and educational efforts and as a member of various agency workgroups.
NOTE: The above statements are intended to describe the general nature and level of the work performed by an employee assigned to this position. This is not an exhaustive list of all duties and responsibilities. Polk County reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.
All HHSA employees may be called upon to perform work during emergency or disaster situations including but not limited to staffing shelters overnight. This service, if required, will take precedence over duties described in this position description.Knowledge, Skills and Abilities
Physical Demands:
The ability to perform all duties associated with the position including, but not limited to lifting, prolonged standing, driving, sitting, bending, stooping, and operating or performing work with associated tools and machines.
The primary purpose of the Economic Services Unit of the Polk County Health and Human Services Agency (HHSA) is to administer public assistance programs to adults, families and children in Polk County. The programs provide a safety net for individuals and families to meet their basic needs and include but are not limited to Work First, Medicaid and Food and Nutrition Services.
Distinguishing Features of the Position
The primary purpose of the Economic Services-Medicaid Unit of the Polk County HHSA is to administer public assistance programs to adults, families and children in Polk County. The programs provide a safety net for individuals and families to meet their basic needs and include but are not limited to Medicaid and Food and Nutrition Services.Duties and Responsibilities
Tasks include: intake, interviewing, program explanation, categorical determination, verification and investigative documentation, periodically reviewing each determination, referrals to agency and community resources.
The worker must meticulously monitor processing procedures to assure that the application is taken timely and processed without delays. This monitoring process assures compliance with federal and state regulations and county policies and it allows the client to be served in the most expedient and judicial manner possible.
Meeting deadlines are a daily part of the responsibilities. The IMC II must be continuously aware of time frames and the importance of exact and efficient scheduling and keep up with all deadlines and must utilize the various internal and state issued reports including but not limited to Case management and the Application Pending Reports on a daily basis. Office materials and workspace must be organized and case files readily available for review.
IMC II employees are expected to obtain and record sensitive information, compute eligibility and enter that data into the NC FAST system to issue applicant I client benefits accurately and timely. IMC II employees are to enter data into the state system, reconcile budgets and respond to data received from outside sources such as FRR and BEER reports.
The IMC II will make the final decision in the case. The Family and Children's Medicaid Lead Worker or Income Maintenance Supervisor second-party reviews all new applications, denials, withdrawals and inquiries plus all reviews for workers who have been employed less than one year or for workers who may be having difficulty implementing policy requirements. For workers who have been employed over one year, fifty (50%) of cases are pulled at random for review.
The IMC II will be involved in fraud cases to the extent necessary to compile the information to refer to the Program Integrity Worker for investigation and as supportive to the case in establishing evidence leading to suspected fraud. The IMC II would be required to assist in the report to the DSS Board, the attorney, court officials and to testify in court should the case move to charges and trial for disposition of the case.
IMC II will take the initial application for the Family and Children's Medicaid Programs. Through the interview process the worker will complete all follow-up activities to verify required information and determine eligibility; process the information to approve or deny the application based on eligibility guidelines; maintain the case as necessary throughout the eligibility period and continue the process through reviews and changes that may occur at any point in the process.
In accordance with policy and procedure, the worker should complete the Medicaid application as soon as possible but no longer than the 45-day time frame for MIC, MAF, MPW, NCHC, Family Planning and Breast and Cervical Cancer. Within that 45-day time frame, the worker must send all mandated notices for any information needed to complete the application and should assist the applicant in any way possible to obtain the required verifications. Case decisions will be made and notices made in the timely manner as required by policy and procedure. Once all required verifications are received, action is to be taken within five (5) workdays to allow the client every possible benefit.
Other Duties As Assigned
Other duties will be assigned and may include but not be limited to participation in community outreach and educational efforts and as a member of various agency workgroups.
NOTE: The above statements are intended to describe the general nature and level of the work performed by an employee assigned to this position. This is not an exhaustive list of all duties and responsibilities. Polk County reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.
All HHSA employees may be called upon to perform work during emergency or disaster situations including but not limited to staffing shelters overnight. This service, if required, will take precedence over duties described in this position description.Knowledge, Skills and Abilities
- Good work ethic
- High level of initiative to learn job responsibilities
- Flexibility within established schedules and relationships
- Ability to function in highly stressful circumstances
- Ability to maintain a high level of professionalism and to conduct business in an ethical manner at all times.
- Ability to establish and maintain effective working relationships with administrative superiors, co-workers, and with community, social and religious organizations by utilizing the Six Principles of Partnership:
- everyone desires respect
- everyone needs to be heard
- everyone has strengths
- judgments can wait
- partners share power
- and partnership is a process
- Ability to work effectively as a team contributor on all assignments
- Significant knowledge of and ability to use modern office procedures, methods, practices, and equipment including computer
- Significant knowledge of and ability to use correct grammar, vocabulary, spelling and office terminology
- Significant knowledge of all programs offered through the agency
- Significant knowledge of general community information and resources
- Ability to independently work with people with courtesy and tact in performing public contact duties that may be sensitive in nature
- Ability to make proper judgments and decisions so that appropriate responses can be made under pressure and in volatile, sensitive situations
- Ability to deal with a large variety of people from all income levels and backgrounds, some of whom speak little or no English
- Considerable self-discipline to independently learn job responsibilities
- Ability to organize and prioritize workflow and coordinate activities efficiently, accurately process policy, and enter data.
- Ability to exercise judgment and discretion in applying and interpreting policies and procedures
- Ability to understand and carry out oral and written instructions
- Ability to express ideas clearly and concisely in oral or written form
- Ability to work overtime when required
- Ability to maintain a valid driver’s license with good driving record and reliable transportation
- Ability to set priorities, implement changes and organize
- Ability to understand the needs and problems of clients / applicants
- Graduation from an accredited associate degree program in Human Services Technology, Social Services Associate, Paralegal Technology, Business Administration, Secretarial Science, or a closely related curriculum.
- Graduation from high school and two years of paraprofessional, clerical, or other public contact experience which included negotiating, interviewing, explaining information, gathering and compiling of data, analysis of data and/or performance of mathematical or legal tasks with at least one year of such experience being in an income maintenance program
- Graduation from high school and three years of paraprofessional, clerical or other public contact experience which included negotiating, interviewing, explaining information, the gathering and compiling of data, the analysis of data and/or the performance of mathematical or legal tasks; or an equivalent combination of training and experience.
- Successful pre-employment drug screen.
- Successful criminal background check.
Physical Demands:
The ability to perform all duties associated with the position including, but not limited to lifting, prolonged standing, driving, sitting, bending, stooping, and operating or performing work with associated tools and machines.
Skills
Compliance
