Definition
Under general supervision, performs advanced eligibility, case review, quality assurance, fact-finding, or related technical work associated with eligibility and benefit determinations; resolves complex eligibility issues, provides technical guidance, and regularly reviews or mentors the work of other eligibility staff; performs related work as required.
The work examples and competencies listed below are for illustrative purposes only and not intended to be the primary basis for position classification decisions.
Work Examples
Reviews eligibility determinations and benefit payments for accuracy and compliance with federal and state requirements, policies, and procedures.
Investigates the eligibility for and the accuracy of payments in the categorical assistance programs.
Determines whether appropriate procedures were followed in establishing continuing, changing, or terminating eligibility; interviews clients, reviews records and documentation, and determines where errors or breakdowns are occurring in the income maintenance process.
Prepares assessments, reports, findings, and recommendations based on case reviews, investigations, or quality-assurance activities. Reviews fraud, overpayment, or other program referrals; gathers and evaluates information, determines appropriate disposition, and coordinates referral for additional investigation or legal action when required.
Confers with supervisor, program staff, attorneys, law enforcement officials, social workers, and other stakeholders concerning complex eligibility or program issues; makes suggestions and recommendations for improvements; prepares reports as requested.
Assists others in the most difficult and complex eligibility cases that require advanced interpretation of program requirements.
Interprets and explains economic assistance programs applicants and clients the categorical assistance programs and regulations; advises them of their rights and responsibilities.
Attends hearings and court actions as necessary.
Participates in hearings and court proceedings as required.
Performs advanced eligibility work across multiple economic assistance programs, coverage groups, or functional areas requiring broader program knowledge than normally required at the journey level.
Reviews cases completed by other eligibility staff for accuracy, completeness, and appropriate application of policy; identifies deficiencies and provides technical guidance regarding corrective action.
Regularly mentors employees learning additional programs, coverage groups, or complex eligibility processes; explains policy application, reviews case work, and provides ongoing technical assistance.
Serves as a technical resource to eligibility staff by researching and resolving difficult policy, system, and case-processing questions.
Assists with special studies or reviews designed to identify trends, errors, training needs, or opportunities to improve program accuracy and administration.
May perform some limited lead or coordination responsibilities that do not constitute full supervisory responsibility.
Competencies Required
Knowledge:
Administrative – Administrative and office procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and workplace terminology.
Computers and Electronics – Circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.
Customer and Personal Service – Principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
English Language – Structure and content of the English language including the meaning and spelling of words, and rules of composition and grammar.
Law and Government – Laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process.
Personnel and Human Resources – Principles and procedures for personnel recruitment, selection, training, compensation and benefits, labor relations and negotiation, and personnel information systems.
Abilities:
Category Flexibility – Generate or use different sets of rules for combining or grouping things in different ways.
Deductive Reasoning – Apply general rules to specific problems to produce answers that make sense.
Inductive Reasoning – Combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events).
Information Ordering – Arrange things or actions in a certain order or pattern according to a specific rule or set of rules (e.g., patterns of numbers, letters, words, pictures, mathematical operations).
Speech Clarity – Speak clearly so others can understand you.
Speech Recognition – Identify and understand the speech of another person.
Written Comprehension – Read and understand information and ideas presented in writing.
Written Expression – Communicate information and ideas in writing so others will understand.
Skills:
Active Listening – Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
Critical Thinking – Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
Monitoring – Monitoring/Assessing performance of yourself, other individuals, or organizations to make improvements or take corrective action.
Reading Comprehension – Understanding written sentences and paragraphs in work-related documents.
Speaking – Talking to others to convey information effectively.
Systems Analysis – Determining how a system should work and how changes in conditions, operations, and the environment will affect outcomes.
Systems Evaluation – Identifying measures or indicators of system performance and the actions needed to improve or correct performance, relative to the goals of the system.
Technology Design – Generating or adapting equipment and technology to serve user needs.
Time Management – Managing one's own time and the time of others.
Troubleshooting – Determining causes of operating errors and deciding what to do about it.
Writing – Communicating effectively in writing as appropriate for the needs of the audience.
Minimum Qualification Requirements
Applicants must meet at least one of the following minimum requirements to qualify for positions in this job classification:
Two years of full-time work experience in in a technical capacity with an economic assistance or related benefit such as FIP, SNAP, or Medicaid, one year of which was at the level of an Eligibility and Benefit Specialist or above.
A total of two years of education and/or full-time experience (as described in number one), where thirty semester hours of accredited college or university coursework in any field equals one year of full-time experience.
Current, continuous experience in the state executive branch that includes one year as an Eligibility and Benefit Specialist.
Effective date: 10/26 KC