Financial Eligibility Specialist

CLOSES: 12/23/25

Why join Carlton County? The Public Health & Human Services department is committed to providing a welcoming environment. We offer:

• 41 hours personal paid time off and 12 paid holidays
• Flexible scheduling and opportunity for part-time remote work
• Comprehensive insurance including medical, dental, vision
• Advancement/professional development opportunities
• Employee Assistance Program
• Employee well-being valued and culture of self-care
• PERA pension plan
• Limited evening and weekend hours may be worked for some positions.
• The Minnesota Rural Public Health Nurse Loan Forgiveness program may be applied for if meet criteria(competitive)
• https://www.health.state.mn.us/facilities/ruralhealth/funding/loans/publichealth.html

Healthcare

• Family Monthly Premium $350.58
• Single Monthly Premium Paid in Full by Employer
• Deductibles covered by VEBA plan funded by Employer

BASIC FUNCTIONS:

• The Income Maintenance (IM) unit administers multiple cash assistance programs, emergency programs, food support, child care assistance programs, health care programs and county burials. The Financial Eligibility Specialist (FES) must quickly and accurately assess the financial, medical and social service needs of a diverse group of households from various economic, social and cultural backgrounds who are experiencing an assortment of hardship and adversity. This includes, but is not limited to, loss of shelter, utility disconnects, households without food, or households with an emergency medical need. Obtain, substantiate, evaluate, and verify client information for multiple public assistance programs. Advise clients of the advantages and disadvantages of programs as they apply to each household member’s unique circumstances. Assist clients in resolving issues with transportation, child care, computer systems, health care access, provider billing, etc.

ESSENTIAL FUNCTIONS:
Intake and Initial Servicing

• Conduct extensive client interviews to obtain pertinent information and documentation to make accurate and appropriate determinations as to what public assistance program(s) a person or family may qualify to receive. Request required documentation and provide required notices.
• Conduct in-home client interviews, including interviews at nursing homes and assisted living facilities, when a client is disabled and/or homebound.
• Work with Medical Transportation Management (MTM) to arrange transportation, meals and lodging and with other social service agencies and medical providers when appropriate. Ensure client access to services either within the county or at an approved medical facility offering medical procedures not available within the county of residence. Educate the client on how to access these services through their managed care health plan. Educate the public on how to access these services privately.
• Evaluate burial contracts, life insurance policies, annuities for availability and uncompensated transfers.
• Collect information regarding long term care insurance policies for evaluation of partnership criteria; apply asset protection policies accordingly.
• Assess immediate need for emergency assistance, expedited food support or medical assistance for pregnant women. Generate and apply solutions to emergency situations arising from evictions, foreclosures, utility disconnects, lack of food or any other emergency.
• Educate clients about the advantages and disadvantages of each program for household members while communicating and translating program rules and regulations at the comprehension level recommended by the state.
• Evaluate circumstances and direct clients to appropriate agencies for additional services.
• Execute a Cost Effective Review (CER) of health insurance and evaluate availability to obtain insurance for each household member. Secure insurance information by contacting employers, child support or providers as necessary and entering compiled information in Third Party Liability (TPL) insurance information system in MMIS. Authorize payment on cost effective insurance policies.
• Process requests for additional assistance as a client’s circumstances change. This may require a new application, interview and determination of eligibility by authorization or denial.
• Establish lines of communication regarding coordination of services between clients and other agencies. Advocate on a client’s behalf to obtain appropriate/available services and benefits with outside agencies/departments to include but not limited to: County Attorney, Sheriff, domestic violence services, funeral homes, Social Security Administration, medical providers, Veteran Services, Legal Aide, group homes/facilities/assisted living/nursing homes/foster homes, the Workforce Center, Benefit Recovery, Salvation Army, Lakes and Pines, child care providers, managed health care plans, Minnesota Department of Human Services, Fond du Lac (FDL) Housing, FDL Social Services, ARHMS workers, Outreach Services, Volunteer Services, Housing & Redevelopment Authority, utility companies, CD counselors, WIC, and other counties, states and tribes. Within the agency, coordination of services will occur with Child Support, Children & Adult Mental Health workers, Public Health Nurses, Family School Support Workers, Disability Social Workers, Adult & Child Protective Services, Fraud Investigators, and the Accounting Unit.
• Educate clients regarding: income spend downs and asset spend downs, liens, estate claims, parental fees, overpayment policies, fraud rules, 60 month time limit, managed care, data privacy rights, work expectations, child care services, clients’ rights and responsibilities and reporting requirements, waiver/LTC services, use of Medical Assistance/Managed Care and EBT cards, child/teen check-ups, rights to appeal, ABAWD 3/36 month limits, MNSURE system, WIC.
• Counsel clients to “self-sufficiency,” which includes a more extensive knowledge and understanding of social, physical and psychological barriers to employment, housing, etc.
• Obtain sensitive information tactfully while assuring compliance with HIPAA regulations. This may include prison records, felony status, pregnancy, paternity, chemical dependency, domestic violence, employment history, disability, mental illness and other health issues.
• Coordinate and utilize multiple complex computer systems and subsystems while utilizing multiple monitors to correctly enter and obtain information from MAXIS, MMIS, MEC2, SIR, PRISM, METS, OnBase and Compass systems. Ensure accurate results by analyzing computer data and comparing program information. Make any necessary changes, authorize or deny benefits, and dictate results on case changes.
• Conduct a manual workaround when computer systems are not accurately determining eligibility.

Ongoing Case Management

• Continually adjust work priorities to manage an ever-changing combination caseload. Ensure a high level of accuracy in order to prevent loss of state and federal reimbursements due to sanctions resulting from errors.
• Authorize adjustments in grants/benefits based on information provided.
• Implement frequent legislative changes that affect each program differently, including additional workarounds due to system limitations.
• Evaluate circumstances and direct clients to appropriate agencies for additional services.
• Assess case information, initiate fraud referrals and assist Fraud Investigator.
• Calculate overpayments and establish claims.
• Act as resource person for other staff and agencies by providing information and consultation. Provide support and training to other Financial Eligibility Specialists.
• Conduct peer and case reviews to ensure quality control measures are applied and comply with federal and state rules and regulations.
• Timely process state reports such as: discrepancy reports, IEVS matches, managed care reports, DAIL messages (daily worker messages which come from Social Security Administration, IRS, Department of Human Services (DHS), Child Support and the state notifying of new jobs, unreported incomes, non-cooperation status and other miscellaneous reports), MEC2 alerts, PARIS Interstate Matches.
• Monitor pending applications.
• Compile data needed to submit to the state for policy interpretation.

General Professional Duties

• Review the appeal summary and supporting documentation to prepare for an appeal hearing. Assist supervisor in presenting the county’s position in the appeal hearing. In the supervisor’s absence, complete the appeal summary and compile the supporting documents in preparation for the appeal hearing.
• Attend mandatory, specific program training, including weekly educational unit meetings.
• Attend meetings, conferences and training deemed necessary by the county/state.
• Make presentations to outside agencies on IM programs and participate in community outreach.
• Perform screening responsibilities by providing general or specific program information either by phone or in person.

MINIMUM QUALIFICATIONS:
Education and Experience:

• Two (2) years of study at an accredited two or four year college or university or similar institution, with emphasis in behavioral sciences, business or closely related subjects (at least 23 quarter credits or 16 semester credits) OR successful completion of the technical college Public Welfare Eligibility Worker diploma program (applicants must be within six months of completion of the program).
• Three (3) years of clerical experience or experience working with the public, or some combination of the two, totaling three (3) years OR two (2) years of clerical experience in a social services/human services agency.
• Note: The successful completion of the technical college Public Welfare Eligibility Worker certificate program will substitute for one (1) year of the required clerical experience or experience working with the public.
• Or an equivalent combination of education and experience sufficient to perform the essential functions of the job.

Training Required:

• None.

Certificates/Licenses Required:

• Valid driver’s license and proof of personal vehicle insurance.

KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:
Required at Entry:

• Knowledge of all public assistance programs.
• Knowledge of other sources of financial support including Social Security, reemployment insurance, veterans benefits, worker’s compensation and disability insurance/pension programs.
• Knowledge of child and adult protection criteria and a general understanding of mental/physical illnesses and human behavior.
• Knowledge of community resources such as housing, food and social service.
• Knowledge of complex law regarding owning real property and when property must be listed for sale.
• Knowledge and understanding of income taxes, tax household composition rules, and types of taxable vs nontaxable income and the associated criteria to make independent calculations based on those rules.
• Knowledge of office procedure, practices and equipment.
• Skill in written/verbal communication with culturally diverse clients. Ability to provide information to diverse clients in a culturally appropriate and sensitive manner.
• Extensive interviewing skills with emphasis on human behavior.
• Skill in detailed entry of data and use of a computer and all necessary software.
• Skill working with detailed information and ability to accurately and rapidly process same
• Ability to be objective/non-judgmental and treat all persons with respect, dignity, sensitivity and tact.
• Ability to analyze changes and establish proper procedures to ensure correct benefit issuance.
• Ability to accurately analyze and evaluate monthly income reports.
• Ability to demonstrate flexibility, including in providing backup support for others, and willingness to create, implement, and adapt to new ways of doing things.
• Ability to work cooperatively, establish and maintain effective working relationships, and use good judgment, compassion and tact when dealing with clients, public, co-workers, agency administration, and other agencies.
• Ability to handle frequent procedural changes due to federal and state law changes.
• Ability to handle distraught clients dealing with personal and financial crisis.
• Ability to organize work, set/reset priorities, make decisions and work independently under stress.
• Ability to interpret, analyze and research legal documents, complex rules, multiple manual materials and bulletins as they apply to income maintenance programs.
• Ability to perform special projects and assignments related to program and procedures and policies.
• Ability to lift and carry up to 20 pounds.