Welfare Fraud Claims Recovery Specialist-Hybrid Work Model

Our Mission: Arapahoe County Department of Human Services (ACDHS) builds strong communities by promoting the safety, independence, and stability of individuals and families.

Our Vision:To end the cycle of poverty and prevent abuse and neglect of children and vulnerable adults (using an integrated Two-Generation approach)

ACDHS uses an integrated Two-Generation (2Gen) approach to address all of the basic human services needs of the entire family unit. The 2Gen approach begins with a mindset focused on family-centered program design and continues with the alignment of services and resources within the department as well as across multiple organizations, resulting in coordinated services to children and adults together (family) in order to create long-term stability and sustainability.

The 2Gen approach builds well-being for families by focusing equally and intentionally on high-quality services in five areas of focus: early childhood education, adult education and employment pathways, economic security, health and well-being, and social capital. This approach will help us achieve our core mission of breaking the generational cycle of poverty, preventing neglect and abuse, and building strong communities.

This position has the responsibility of gathering data to establish fraud overpayment claims based on reports from the Welfare Fraud Investigators, managing information received from the Public Assistance Reporting Information System (PARIS), preparing investigation summaries, filing and managing litigation with the Office of Administrative Courts and more. The person in this position must be able to understand the eligibility requirements for programs such as Colorado Works, Food Assistance, Family Medicaid, Child Care, and others. This position must interpret and apply constantly changing county, state and federal regulations and policies.

• Prepares claims based on information and reports from the Welfare Fraud Investigators.
• Review all relevant data from the case files, CBMS, or other systems and calculate the correct benefit independently from the system.
• Compile claim packet with supporting documentation for valid claims and forwards completed packets to the collection staff. Completes necessary and detailed documentation in CBMS of findings, regardless of validity.
• Review welfare fraud referrals that come into the county via the Fraud Referral Inbox, hotline and internal county submissions. Input referrals to the Investigators after thorough analysis of the case history and confirmation of irregularities.
• Complete necessary supporting documentation for the referral and assist with the welfare fraud investigation as necessary.
• Participate in groups, activities and training to enhance knowledge in program areas, computer systems, and policies regarding overpayment claims and recovery.
• Prepare for and represent the department in state hearings.
• Monitor and establish claims based on the PARIS Match Report.
• Conduct trainings with investigators to cross train role, CBMS and claims knowledge.
• Prepare and follow-up on administrative subpoena's.
• Prepare, edit and file Investigations Hearing Summaries and coordinate all related evidence.
• Manage administrative court docket and witness prep meetings, as well as Investigator meetings with the prosecutor's office.
• Commence litigation in the form of Summons and Complaint, establish repayment agreements.
• Post judgment litigation to include garnishee liability hearings, contempt hearings, judgment debtor examinations and more.
• Record and upload into local system financial transactions for the collections team.

REQUIREMENTS:

Skills, Abilities and Competencies:

• Thorough and detailed knowledge of CBMS and how to navigate through the screens and what the screens mean. Ability to run reports in Cognos.
• Thorough and detailed knowledge of the assistance programs processed in CBMS. Detailed knowledge of eligibility rules, how benefits are calculated and methods of collecting for valid claims.
• Analyzes complex situations related to program eligibility and benefit payments, understand all the information, and then draw conclusions from the analysis.
• Summarizes findings and clearly communicates them to management, other staff, and clients. Communications will be written form, in spreadsheet form, and/or verbal. Strong written and verbal skills are required.
• Demonstrates the initiative to learn and research required program rules, computer applications and related concepts. Applies new information to complex situations and draws useful conclusions in an area where there is limited standardization and guidance.
• Organizes and prioritizes work activities so that work is completed thoroughly, accurately, and efficiently. Must be able to work on different cases, at various stages within the process, at the same time. Excellent time management skills are required.
• Working knowledge of state and county computer systems and strong ability to learn new systems.
• Ability to demonstrate effective customer service skills.
• Ability to work independently and as a team member in an organized, productive, and collaborative environment.
• Communications extend beyond the division to others within the agency, other counties, and the state. The ability to communicate effectively with strong oral and written skills is required. Interacts professionally with team members in a collaborative problem-solving environment. Ability to objectively listen and evaluate others' comments and resolve differences of opinion in a professional manner.
• Ability to establish and maintain effective working relationships with co-workers, contacts throughout the agency, other counties, the state, and clients.

Behavioral Competencies (these are required for all positions at ACG):

Accountability Accessibility Inclusivity Integrity

Education and Experience:

• Associate degree or two years of college
• Three or more years of related experience in welfare benefits, claims, and/or collections may be substituted for educational requirements.
• Any equivalent combination of education and work experience that satisfy the requirements of the job will be considered.

Preferred Education and Experience:

Pre-Employment Additional Requirements:

Post-Employment Requirements:

WORK ENVIRONMENT:

PHYSICAL DEMANDS:

The following are some of the physical demands commonly associated with this position.

• Spends 50% of the time sitting and 50% of the time either standing or walking.
• Occasionally lifts, carries, pulls or pushes up to 25 lbs.
• Occasionally uses cart, dolly, or other equipment to carry in excess of 25 lbs.
• Occasionally climbs, stoops, kneels, balances, reaches, crawls and crouches while performing office or work duties.
• Verbal and auditory capacity enabling constant interpersonal communication through automated devices, such as telephones, radios, and similar; and in public meetings and personal interactions.
• Constant use of eye, hand and finger coordination enabling the use of automated office machinery or equipment.
• Visual capacity enabling constant use of computer or other work-related equipment.

Below, please list any special physical demands associated with this position. For instance, exposure to hazardous environments, blood borne pathogens, extreme heat/cold, use of power equipment or machinery, wearing of PPE (personal protective equipment).

Definitions:

Occasionally: Activity exists less than 1/3 of the time.

Frequently: Activity exists between 1/3 and 2/3 of the time.

Constantly: Activity exists more than 2/3 of the time.

** In accordance with Senate Bill 23-058, applicants understand that Arapahoe County will not request or require the applicant to include their age, date of birth, or date of attendance/graduation date on the initial application. Applicants understand that Arapahoe County can request or require an individual to provide documentation including copies of certification, transcripts, and other materials created by a third party. The applicant understands that the applicant can redact, if they so choose, information that identifies age, date of birth, or dates of attendance/graduation from an educational institution on those requested/required certification, transcripts and other materials created by a third party.

Toll Free Applicant Technical Support: If you experience technical difficulty with the NEOGOV system (i.e. uploading or attaching documents to your online application), call NEOGOV technical support at 855-524-5627. Helpful hints: if you are having difficulty uploading or attaching documents to your application, first, ensure your documents are PDF or Microsoft Word files, and second, close the document before you attempt uploading (attaching) it.