Job Description

Overall Job Objective

What Success Looks Like In This Job

This is an intermediate level position that determines initial eligibility for Health First Colorado (formerly Medicaid), including Long Term Care and certain specialty programs. This position works on-site at specified community partner locations.  This position operates under general supervision.

Examples of Duties for Success

* Examines applications to determine applicants/participants income, resources, household composition and employment status to assess their eligibility for medical assistance.
  • Reviews applications for accuracy and completeness, and makes requests for information regarding incomplete forms and missing documentation. Verifies required information by appropriate methods: e.g. phone calls to employers; applicants; computer database inquiries (interfaces); statistical reports from the State and/or change or status reports turned in by clients to determine program eligibility.
* Explains program eligibility requirements to applicants, including all rules and regulations, his/her rights and responsibilities, available benefit dates, reason for approval or denial and the right to appeal. 
  • Interface on a daily basis with statewide computer system requiring accurate and complete data entry of information. Interprets and evaluates computer generated data to determine application to individual case processing for approvals, changes, denials and discontinuations.
  • Utilizes computer daily for inquiry and data entry for preparation of complex correspondence, spreadsheet development and record maintenance and research. Maintain client records within the Colorado Benefit Management System (CBMS) and electronic case file in the Department's electronic document management system. Document all actions taken on applications and cases within CBMS.
  • Completes monthly reports that are instrumental in discovering discrepancies that could affect participant's eligibility.
  • Works closely with contracted community partner staff to share relevant information.
  • Participates in the dispute resolution process with applicants/participants when requested. Prepares evidence, attends and testifies in state level hearings on applicant/participant appeals. 
  • Partners with service providers and other agencies to achieve positive outcomes for clients.
  • Performs other related duties and responsibilities as required. 

Qualifications for Success

  • * Knowledge of all public assistance programs, as applicable.
    * Conduct effective interviews relevant to determining eligibility.
    * Knowledge of CBMS.
    * Apply basic math and read, interpret, and apply rules and regulations.
    * Communicates clearly and concisely, both orally and in writing.
    * Differentiate between relevant and non-relevant information when making eligibility decisions.
    * Input data accurately and detect errors/make corrections.
    * Skills related to customer service.
    * Ability to establish, maintain, and foster positive and harmonious working relationships with those contacted in the course of work. 

More Qualifications for Success

  • Experience: This position requires at least one year experience in an entry level position determining eligibility in CBMS for Medicaid.
  • Education and Training: High School Diploma or GED equivalent. Satisfactory completion of an Associate's or Bachelor's Degree in business, behavioral science, or another appropriately related field may substitute for experience on a year for year basis.
  • License or Certificate: None.
  • Background Check: Must pass a criminal background check.
Ability to work in a standard office environment.

Special preference will be given to Bilingual applicants.

Application Instructions

Please apply for this position by following the link provided below. A new window will open on your screen and you will be directed to the Adams County Government employment website. From there, please follow the application directions provided. PLEASE MAKE SURE TO SAY YOU SAW THE AD ON JOBING.COM!

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