CSHCN Services Program Eligibility Specialist
Job Description:
Administrative Asst II
Under the supervision of the Children with Special Health Care Needs Services Program Supervisor, provides routine and advanced administrative support necessary to carry out daily program operations for the Children with Special Health Care Needs Services Program (CSHCN-SP) area and greater Specialized Health and Social Services (SHSS) program as needed. Provides information and referral for incoming calls and visitors. Processes eligibility applications for the CSHCN-SP, which includes: reviewing applications for accuracy, interviewing clients, collecting program required verification, and documenting case information in assigned databases. Coordinates successful case disposition and effective client services by referring clients to DSHS medical case managers as needed. Performs duties to support case management efforts of the region, including: entering and retrieving client information into/from assigned databases; and transferring and processing case management files according to the specific records retention policy for each case type. Performs duties under moderate supervision with limited latitude for the use of initiative and independent judgment. May train or mentor others. Performs other duties as assigned by Program Manager or regional leadership
Essential Job Functions:
(45%) Provides administrative and technical support services for the Children with Special Healthcare Needs Services Program (CSHCN-SP), Personal Care Services (PCS), Community First Choice (CFC), and other SHSS programs. Answers and routes telephone calls, takes messages, and greets and directs visitors to the appropriate staff. Prepares, reviews and maintains program reports and documents utilizing standard office equipment and software. Maintains filing systems in compliance with applicable state and federal statutes. Processes and disseminates program and regional correspondence. Participates in the organization, coordination, and tracking of a wide variety of regional program processes and events. May train or mentor others.
(45%) Processes eligibility applications for the CSHCN-SP program. Interviews consumers to determine eligibility for services. Provides eligibility information to internal and external customers. Inputs information and scans eligibility applications and associated documents into the appropriate database systems. Documents case activity in compliance with applicable state and federal statutes. Processes and disseminates related correspondence and documents.
(10%) Performs other duties as assigned. Completes routinely scheduled rotations at the regional headquarters reception area and switchboard. Actively participates and/or serves in a supporting role to meet the agency's obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location. This position periodically includes travel. The employee must possess a current valid Class C Texas driver's license. Safe operation of either a state-owned vehicle or personal vehicle is required to conduct state business and an acceptable driving record must be maintained in accordance with DSHS Policy OS-3901, Fleet Operations and Management & Procedures and standards developed by the Texas Department of Public Safety. Compliance with DSHS Immunization Policy required: serologic evidence of immunity to, or documented evidence of vaccination against, measles, mumps, rubella, varicella (chickenpox), Tdap, annual vaccination against influenza (and hepatitis B if applicable).
Knowledge Skills Abilities:
Knowledge of: CSHCN-SP program policy, requirements, and procedures; Medicaid programs and the client eligibility process; related children's health programs such as CHIP, CSHCN-SP, SSI; healthcare delivery systems in Texas; Health Insurance Portability and Accountability Act (HIPAA); agency policies and procedures; best practices pertaining to office etiquette and administrative procedures.
Skilled at: planning, prioritizing, and organizing workload; developing, compiling, and analyzing reports; problem resolution and effective decision-making; use of software applications, including Microsoft office products.
Ability to: communicate effectively, verbally and in writing; interpret and apply program policies, procedures, and regulations; establish and maintain effective working relationships with internal and external customers; work in teams and take direction from others; manage multiple tasks and meet deadlines; adhere to DSHS and HHS policies and procedures; function independently and with great initiative in the performance of professional duties.
Registration or Licensure Requirements:
Valid Class C Driver’s License Initial Selection Criteria:
2 years’ experience delivering customer service to a diverse population.
Experience with eligibility and healthcare delivery systems in Texas.
Proficient in use of Microsoft office products.
Additional Information:
MOS Code:
42A, YN, 0111, 3A1X1 HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.
I-9 Form - Click here to download the I-9 form.
In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.