Appeals & Mitigation MEPD Advisor II

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Medical Elig Spec II-Medical Elig Spec II-The Texas Health and Human Services Commission (HHSC) seeks
highly qualified candidates to fill the MEPD Advisor II position within the Office of Medical and Social Services
(MSS), Access and Eligibility Services (AES) Eligibility Services Division. The MSS is driven by its mission to
connect people, services, and supports by helping individuals and families in need of food, medical care, cash
assistance and other social services. The ideal candidate will thrive in an environment that emphasizes innovation
through new ideas, striving for excellence by taking pride in your work, embracing our differences as a source of
strength, accomplishing more through partnership, leading by example, and learning for continuous improvement.
(***Open to current AES/MEPD Employees Only ***)

MEPD Advisor II (CT) processes appeal requests and represents the agency during the Fair Hearing Process.
Accurately determines eligibility for Medicaid for the Elderly and People with Disabilities (MEPD) programs. Work
involves interviewing clients in person or via outbound phone call, documenting information gathered, determining
eligibility for benefits, verifying case data, explaining program benefits and requirements. Work involves making
outbound calls to verify client information. Reviews eligibility of clients for ongoing services. Job requires detailed
oriented individuals with ability to apply complex policies and procedures. May be assigned to special projects as
needed.

Esstenital Job Functions: Maintains a regular and predictable work schedule. Processes Fair Hearing requests, testifies during Fair
Hearings as a technical authority on eligibility issues, and implements Fair Hearing decisions. Reviews case
records to determine validity and accuracy of eligibility determinations made by local office Advisors. Conducts
case reviews and obtains information by observing and recording findings. Provides guidance to regional staff
concerning potential errors made on a case. Resolves complaints and escalated issues. Counsels’ clients on
social services programs, and other state and federal regulations. Research policies and collaborates with
regional attorneys. Confers with Legal and Policy staff to obtain additional information bearing on hearings.
Coordinates hearing activities, to include notifying key stakeholders of upcoming hearings to ensure that they
attend said hearings as a witness. Interviews clients or authorized representatives via phone or in person to
gather information to determine eligibility for benefits. Processes changes to client status, overpayments, and
adjusts or restores benefits. Obtains, verifies, and calculates income and resources to determine client financial
eligibility. Conducts collateral cold calls via conference line to obtain verification of client information. Documents
case records using automated systems to form a record for each client. Communicates effectively with others
(internally or externally) to provide, exchange, or verify information, answer inquiries, address issues, or resolve
problems or complaints. Performs shadowing activities with incoming staff. Perform other duties as assigned.
Must be able to work occasional overtime, as required by management, outside of normal hours of operation,
which may include weekends when called upon. Must be able to work in a highly stressful and fast paced
environment, under constant pressure to meet required deadlines, interview service times, standards, and
thresholds.

Registrations, Licensure Requirements or Certifications: NA

Knowledge Skills Abilities: Knowledge of interviewing techniques to obtain highly personal information, make inquiries, and resolve conflicting
client statements • Ability to perform basic arithmetic functions, including using decimals and computing
percentages • Ability to maintain effective working relationships with others • Ability to actively listen to clients,
elicit, relate and evaluate information, and interpret terms • Ability to complete work within specified deadlines •
Ability to read, understand, and apply a variety of interrelated instructions, such as those found in guidelines,
regulations, and policies • Ability to establish priorities according to relative importance and deadlines, set goals,
and manage time efficiently • Ability to identify conflicting information provided by the clients or their authorized
representatives • Ability to operate computer equipment • Skill in establishing and maintaining effective working
relationships, including the ability to work with people under pressure, negotiate among multiple parties, and
resolve conflicts • Skill in organizing, prioritizing, writing, proofreading, editing, filing, record keeping, and
interpersonal communication • Skill in communicating effectively both verbally and in writing. • Ability to work in a
dynamic fast paced and constant changing environment • Ability and skill to perform data entry • Knowledge of
computer functionality and use of Internet, Microsoft Word, Excel and Outlook • Ability to work independently and
under limited supervision

Initial Screening Criteria: High School Diploma or GED equivalent required. Sixty (60) semester hours from an accredited college or
university preferred. Two years’ relevant customer service experience with public contact required which can
include retail, call center, clerical, hospitality, banking, receptionist, or similar customer service experience. Twelve
(12) months experience as a MEPD Advisor II within the last year required. TIERS and Eligibility Workload
Management System (EWMS) experience within the last year preferred. Experience in Medicaid policy and
procedures within the last year is required. Experience using manual and/or automated systems to determine
eligibility for MEPD Medicaid programs within the last year is required. Experience to indicate a general
understanding of the knowledge, skills, and abilities needed to perform duties required. Prefer experience in social
service environment which may include but not limited to interviewing clients, gathering personal information, or
making eligibility determinations. Applicant must indicate willingness to travel as indicated on job posting in order
to be considered for employment. Applicant must indicate willingness to work outside the normal business hours
of 8 to 5, Monday-Friday and willingness to work weekends as needed.

Additional Information: 
Note: Current employee applicants should list each position held separately. For example, MEPD
Advisor I job experience must be listed separately from MEPD Advisor II job experience.
Number of positions to be filled: 2. This position is located at: anywhere within the state of Texas in which there is
office availability.
Based on training requirements and previous program eligibility experience, former Access and Eligibility (AES)
employees may be considered for rehire at the MEPD Advisor II/Medicaid Eligibility Specialist II / Salary Group
B13. Incumbents are automatically upgraded when tenure and performance requirements are met. Current MEPD
Advisor II/Medicaid Eligibility Specialist II / B13 applicants, if selected, will maintain current job classification and
salary group. Please note that while the posted salary range for this position is $2953.25 to $4365.66, only former
and current Health and Human Services Commission employees will be offered a salary above $2953.25 monthly.
Current employees promoting into this position will be offered a salary that meets Human Resources salary
guidelines for promoting employees. Former employees may be offered a salary above $2953.25 if they have
recent MEPD or MEPD eligibility experience. Recent experience includes any experience within one year prior to
the application closing date. Applicants who are not current or former Health and Human Services Commission
employees will be offered a salary of $2953.25
Applicants may not have a history of substantiated fraudulent activity against HHSC or any programs it
administers. Applicants who have a non-fraud overpayment with an outstanding balance must agree to repay the
overpayment balance as a condition of employment.
The Texas Health and Human Services Commission is committed to hiring veterans and creating a work
environment that values and retains the skills that service members bring to the job. A veteran is an individual who
has served in *the Army, Navy, Air Force, Coast Guard, or Marine Corps of the United States or the United States
Public Health Service under 42 U.S.C. Section 201 et seq., as amended; *the Texas military forces as defined by
Section 437.001 of Texas Government Code; or *an auxiliary service of one of those branches of the armed
forces; and *has been honorably discharged from the branch of the service in which the person served. Please
Note that Military Occupations that relate to the initial selection criteria and registration or licensure requirements
for this position may include 42A. For more information see the Texas State Auditor’s Military Crosswalk at
http://www.hr.sao.state.tx.us/Compensation/JobDescriptions.aspx. VETERANS: Use your military skills to qualify
for this position or other jobs! Go to www.texasskillstowork.com to translate your military work experience and
training courses into civilian job terms, qualifications and skill sets. Also, you can compare this position to military
occupations (MOS) at the Texas State Auditor’s Office by pasting this link into your browser:
http://www.hr.sao.state.tx.us/Compensation/JobDescriptions.aspx. For more information on military occupational
specialty codes, see the Military Crosswalk Guide.
HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.
I-9 Form - Click here to download the I-9 form.
In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable
accommodation during the hiring and selection process for qualified individuals with a disability. If you need
assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If
you are contacted for an interview and need accommodation to participate in the interview process, please notify
the person scheduling the interview.

Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.

Active Duty, Military, Reservists, Guardsmen, and Veterans:

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.

HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form