QUALITY CONTROL REVIEWER

Definition

Under supervision in the Department of Human Services, performs the office and field work reviewing and verifying client eligibility for a variety of Department assistance programs; does other related work.

Examples of work

• Verifies that cases selected for review were receiving some type of assistance during the review sample month and prepares review forms for assigned cases.
• Visits the County Welfare Agencies to review case and agency administrative records; reads and analyzes cases and public assistance forms; analyzes the validity of the agency's decision regarding the amount or type of assistance.
• Reviews administrative decisions for compliance with Federal and State public assistance policies, standards and regulations; contacts the agency's administrator regarding discrepancies.
• Visits the home and interviews the client or authorized representative receiving public assistance; secures client's signature on releases for use during collateral investigations.
• Records all information obtained during the interview.
• Verifies the validity of client documents (birth certificates, social security card, rent receipts, pay stubs, and other papers).
• Researches County Clerk's Office records to determine the client's property and resources; contacts landlords to verify rental payments, residence and household composition.
• Researches Local and State Bureaus of Vital Statistics for birth, marriage and death records; contacts the Social Security Administration office to verify various benefits and Medicare.
• Contacts health and life insurance companies to verify benefit amounts and policy values.
• Contacts relatives and other interested parties to investigate potential financial resources and/or verifies possible third party liability.
• Visits social agencies and government offices to verify program requirements; makes contacts with other government and public assistance program agencies for cross-reference of benefits.
• Contacts the recipient's employer or former employer for salary verification, benefits, retirement pension, and compensation.
• Establishes and maintains cooperative and working relationships with the collateral contacts to receive a prompt and accurate verification.
• Analyzes data and determines the client's eligibility and/or validity of the benefits decision made by other agencies.
• Prepares correspondence.
• Prepares reports containing findings, conclusions and recommendations.
• May be required to learn to utilize various types of electronic and/or manual recording and information systems used by the agency, office or related units.

Experience

Two (2) years of experience in work involving the investigation of personal financial matters, credit, or other similar investigations.

License

Appointee will be required to possess a driver's license valid in New Jersey only if the operation of a vehicle, rather than employee mobility, is necessary to perform the essential duties of the position.

Knowledge, skills and abilities

Knowledge of investigative methods. Knowledge of interviewing techniques. Knowledge of various sources of recurring income, i.e. employment, unemployment benefits, etc. Knowledge of sources and methods used to obtain information regarding clients, finances and financial resources. Ability to conduct research. Ability to perform intricate mathematical calculations for public assistance determinations. Ability to prepare reports and correspondence. Ability to read and interpret laws, rules, and regulations and apply them to specific situations. Ability to investigate, gather and organize facts. Ability to work independently. Ability to establish and maintain cooperative working relationships. Ability to identify and follow investigative leads into a client's financial background. Ability to maintain records and files. Ability to learn and utilize various types of electronic and/or manual recording and information systems used by the agency, officer or related units. Ability to read, write, speak, understand, or communicate in English sufficiently to perform the duties of this position. American Sign Language or Braille may also be considered as acceptable forms of communication. Persons with mental or physical disabilities are eligible as long as they can perform the essential functions of the job after reasonable accommodation is made to their known limitations. If the accommodation cannot be made because it would cause the employer undue hardship, such persons may not be eligible. This job specification is applicable to the following title code(s) which are different work week or work month and/or variants of the job class title: Job Spec Code State, Local or Common Class of Service Work Week State Class Code Local Class Code Salary Range

Note

The examples of work for this title are for illustrative purposes only. A particular position using this title may not perform all duties listed in this job specification. Conversely, all duties performed on the job may not be listed. NOTE: Appointments may be made to positions requiring bilingual skills. Bilingual in Spanish and English. SPECIAL SKILL Applicants must be able to read, write, speak, understand, or communicate in Spanish and English sufficiently to perform the duties of this position. Applicants who do not possess the required experience may substitute semester hour credits from an accredited college on a year-for-year basis with thirty (30) semester hour credits being equal to one (1) year of experience. SCNE15N/AH15-Bilingual In Spanish & EnglishSCNE15N/AH15- This job specification is for government use only. Salary range is only applicable to state government. Local salaries are established by individual local jurisdictions. 01/11/2001