Fair Hearing Eligibility Specialist

The Office of the General Counsel/Fair Hearing Administration of the Department of Social Services oversees DSS's fair hearing process, an administrative law procedure designed to resolve disputes concerning benefits, services, and actions in a variety of programs administered by DSS. DSS Fair Hearing Administration is responsible for providing representation of the Agency at NYS Administrative Hearings in the following program areas: Cash Assistance (CA), Supplemental Nutrition Assistance Program (SNAP), IREA, HASA and MISCA

• Medical Assistance (MA).

Fair Hearing Administration is recruiting for six (6) Eligibility Specialists, Level II to function as a Fair Hearing Eligibility Specialist for their MICSA Fair Hearing Unit. The Eligibility Specialist's duties and responsibilities include, but are not limited to the following:

• Gather information regarding client's eligibility for PHI from submitted forms, via face to-face contact, or via telephone to ensure compliance with State fair hearings decisions. Determine PHI eligibility based upon the pertinent laws, rules, regulations, and procedures in order to provide the appropriate action for each Fair Hearing appellant.

• Contact appellants to discuss eligibility and resolve as many cases as possible before the hearing is scheduled. Examine and verifies client's eligibility information using the WMS and FHIS and examines the client's Aid to Continue (AC) eligibility and its ramifications for the case and instigate voluntary withdrawals from the fair hearing process.

• Process extension of Medical coverage for clients entitled to AC and whose Medicaid eligibility is scheduled to expire or has already expired. Processes "clock down" lists by extending coverage for appellants whose hearings have not been scheduled or have been rescheduled.

• Provide information regarding PHI eligibility to current and potential clients via telephone and in person.

• Transmit the required Withdrawal of NYS OTDA Fair Hearing Request form (MAP- 316P) to the appellants in instances where the voluntary withdrawal is agreed to. Review the form to ensure that it is duly signed and complete upon its return. This form provides written proof that the appellant has withdrawn their request for a fair hearing.

• Maintain log of contact with clients, noting issues that have been resolved and cases that have been either resolved or withdrawn. Forward the MAP-316P form to the Record Management/Carfare Unit for addition to the appellant's file. Prepare daily, weekly, and monthly activity reports for submission to supervisory staff.

• Consult with the Unit Supervisor on overall problems and complicated cases as needed.

Minimum Qualifications

1.Completion of 60 semester credits at an accredited college; or

2.A four-year high school diploma or its educational equivalent and two years of full-time satisfactory experience in one or more of the following areas; performing the work described below:

a. Interviewing, gathering information and/or preparing necessary documentation for the purpose of making decisions concerning eligibility for public assistance or unemployment, health benefits, social security, casualty, property or liability insurance, or other similar benefits; or

b. Performing bookkeeping, bank teller duties, housing office teller duties, purchasing agent, assistant store manager, sales representative responsible for accounts, or customer service representative responsible for making determinations; or

c. Dealing with social service agencies or aiding individuals in solving housing, social, financial or health problems as a community organization representative; or

3.A satisfactory combination of education and/or experience equivalent to "1" or "2" above. College education may be substituted for the experience in "2" above on the basis that 30 semester credits from an accredited college may be substituted for each year of required experience. However, all candidates must have at least a four year high school diploma or its educational equivalent.

Special Note

Work experience which provides only incidental opportunities to perform the job duties as described in "2a", "2b" and "2c" above are not acceptable for meeting the minimum qualification requirements. Examples of unacceptable work experience include, but are not limited to, experience as a token clerk, check-out clerk, sales clerk, teacher's aide, cashier, receptionist or secretary.

Preferred Skills

• Must have extensive background in Medicaid eligibility and be able to complete all MA eligibility transactions in WMS.

• Must be up to date in Medicaid Savings Program and how to accrete a case in the Emedny system.

• Must be able to communicate well with all consumers and act in a professional manner even when confronted with difficult consumers.

• Must be able to move the interviews along to allow to meet the deadlines imposed by the State OTDA.

• Work well under pressure, as well as, manage the interview process.

• Must be organized, self-sufficient and be an independent starter.

• The worker must be proficient in WMS eligibility actions, understand all budgeting types, understand Edits, Emendy and proficient in working with word and excel reports.

55a Program

This position is also open to qualified persons with a disability who are eligible for the 55-a Program. Please indicate at the top of your resume and cover letter that you would like to be considered for the position through the 55-a Program.

Public Service Loan Forgiveness

As a prospective employee of the City of New York, you may be eligible for federal loan forgiveness programs and state repayment assistance programs. For more information, please visit the U.S. Department of Education's website at https://studentaid.gov/pslf/

Residency Requirement

New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview.

Additional Information

The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected characteristic, including but not limited to an individual's sex, race, color, ethnicity, national origin, age, religion, disability, sexual orientation, veteran status, gender identity, or pregnancy.