Income Maintenance Caseworker II - Adult Medicaid

Primary Purpose – The Income Maintenance Caseworker II position is responsible for establishing eligibility for Medicaid applicants, maintaining an ongoing caseload, and completing monthly recertifications for Private Living Medicaid, utilizing NCFAST.   The caseworker must be easily accessible to their clients, representatives, Power of Attorney’s, hospital staff, and attorneys regarding eligibility. Reacting to reported changes in an appropriate and timely manner is required.

 This worker is required to read and interpret Medicaid policy for all program areas, along with Dear County Director Letters, Change Notices, and Job Aids as issued by the State/NCFAST. This caseworker must interact and communicate exceptionally well with supervisors, co-workers, hospital staff, and the public.

This position is from 8:00 am until 5:00 pm., Monday through Friday with one hour for lunch. Overtime is required as needed and will include overtime during the week and on weekends, on occasion.

The worker in this position will take applications and determine eligibility for MAA, MAB, MAD, MQB, HCWD, FPP, and MCV when applicable. The worker will take courtesy applications for surrounding counties when applicable.  

1)This worker is responsible for reporting directly to the Adult Medicaid PLA Supervisor. This worker will work with caseworkers in all areas of Adult Medicaid.

2)Worker will be responsible for assisting the Adult Medicaid Supervisors in the administration of the Adult Medicaid Programs in the area of Private Living Medicaid and Family Planning Program. Duties will include entering/processing applications for Medicaid in the listed program areas in NCFAST. Worker will be involved in the actual daily functions in all program areas that will involve taking and processing of applications, recertifications and changes.   

3)This worker must be very knowledgeable with the various programs in Income Maintenance, such as Family & Children’s Medicaid and Adult Medicaid. The ability to read and interpret policy and Job Aids is required.  Attention to detail is required.

4) Worker must have considerable knowledge of all agency and community programs and services which could affect the client/applicant.  This worker must have the ability to analyze, interpret rules and regulations for various programs.  Worker must have the ability to understand the needs and problems of the clients/applicants and assist with irate clients when needed. This worker must be able to function within structured time frames and meet deadlines timely.  In addition to explaining various program guidelines, the worker must also explain the rights and responsibilities of the client/representative and the appeal rights.

5)All applications and recertifications must be processed timely according to the timely State standards. Workers must verify all electronic verifications such as AVS, OVS, and Work Number verifications within NCFAST. Workers must also verify life insurance, real and personal property, Register of Deeds, clients age, and disability verification as needed. Application deadlines are 45, 60, and 90 days however there are circumstances when the case may pend for up to twelve months.

6)Employee will be expected to work in emergency shelters and/or perform related disaster tasks and perform other reasonable tasks requested by the Deputy Director or Director.  

III. Other Position Characteristics

1)Accuracy Required in Work:  Accuracy is of the utmost importance.  This position requires mental concentration at all times because it is necessary that work be done as mandated by policy in all Adult Medicaid & Family & Children’s programs.

2)Consequence of Error: Perfection is demanded in this position.  The results of an error in determining eligibility could mean county charge backs and the authorization of benefits in error. The workers decisions can be critical to continued assistance to clients and the appropriate reimbursement to medical institutions for services rendered.  

3)Instructions Provided to Employee:  Instructions may be written and/or verbal.

4)Guidelines, Regulations, Policies and References Used by Employee: The type of guidelines and reference sources used in making decisions and carrying out the duties of this position are all programs manuals, FAST Help, Learning Gateway, DMA letters, Change Notices, Terminal Messages, and supervisory instructions. The worker will also utilize guidelines, memorandums, and etc. of Nash County DSS.   

5)Supervision Received by Employee:  Supervisory sessions are conducted on individual basis or as needed.  The worker prepares a conference agenda and submits to Supervisor prior to conference if needed.  In addition, there are group sessions called at the discretion of the Supervisor.   Worker will attend staff meetings of the Adult Medicaid Unit when changes occur or new policy is implemented.    

Thorough knowledge of Private Living Medicaid and NCFAST.  Considerable knowledge of all agency and community programs and services which could affect the applicant.  General knowledge of all income maintenance programs.  Good mathematical reasoning and computational skills.  Ability to read, analyze, and interpret a variety of regulations, policies and procedures of varying complexity.  Ability to work independently and prioritize work.  Ability to understand the needs and problems of applicants.  Ability to perform caseworker function under and within structured time frames.

One years of experience as an Income Maintenance Caseworker.

Salary : $42,049 - $67,715