Appeals and Mitigation Eligibility Advisor IV

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.

Functional Title: Appeals and Mitigation Eligibility Advisor IV

Job Title: Eligibility Advisor IV

Agency: Health & Human Services Commission

Department: Appeals & Mitigation

Posting Number: 14379

Closing Date: 09/03/2026

Posting Audience: Internal and External

Occupational Category: Community and Social Services

Salary Range: $3,409.83 - $5,094.16

Pay Frequency: Monthly

Salary Group: TEXAS-B-16

Shift: Day

Additional Shift: Days (First)

Telework: Travel: Up to 30%

Regular/Temporary: Regular

Full Time/Part Time: Full time

FLSA Exempt/Non-Exempt: Nonexempt

Facility Location: Job Location City: WICHITA FALLS

Job Location Address: 925 LAMAR ST

**Other Locations: Abilene; Alamo; Alice; Alpine; Alvin; Amarillo; Anahuac; Andrews; Angleton; Anson; Aransas Pass; Archer City; Arlington; Athens; Atlanta; Austin; Bacliff; Ballinger; Bandera; Bastrop; Bay City; Baytown; Beaumont; Bedford; Beeville; Bellville; Big Spring; Boerne; Bonham; Borger; Bowie; Brady; Breckenridge; Brenham; Brownfield; Brownsville; Brownwood; Bryan; Burnet; Caldwell; Cameron; Canton; Canutillo; Carlsbad; Carrizo Springs; Carrollton; Carthage; Center; Centerville; Childress; Clarksville; Cleburne; Cleveland; Coldspring; Columbus; Conroe; Copperas Cove; Corpus Christi; Corsicana; Crockett; Crosby; Crystal City; Cuero; Cypress; Daingerfield; Dallas; Decatur; Del Rio; Denton; Dickinson; Dumas; Duncanville; Eagle Pass; Eastland; Edinburg; El Paso; Elgin; Elsa; Ennis; Fabens; Falfurrias; Floresville; Fort Stockton; Fort Worth; Fredericksburg; Gainesville; Galveston; Garland; Gatesville; Georgetown; Giddings; Gilmer; Goliad; Gonzales; Graham; Granbury; Grand Prairie; Grapevine; Greenville; Hallettsville; Hamilton; Harlingen; Haskell; Hearne; Hemphill; Hempstead; Henderson; Hereford; Hillsboro; Hondo; Houston; Humble; Huntsville; Hurst; Irving; Jacksonville; Jasper; Johnson City; Jourdanton; Karnes City; Katy; Kaufman; Kerrville; Killeen; Kingsville; Kingwood; Kirbyville; La Grange; Lake Jackson; Lake Worth; Lamesa; Lampasas; Lancaster; Laredo; Levelland; Lewisville; Liberty; Linden; Littlefield; Livingston; Llano; Lockhart; Longview; Lubbock; Lufkin; Lumberton; Madisonville; Marble Falls; Marfa; Marlin; Marshall; Mcallen; Mckinney; Mercedes; Meridian; Mesquite; Mexia; Midland; Mineola; Mineral Wells; Mission; Monahans; Mount Pleasant; Mount Vernon; Nacogdoches; Navasota; New Boston; New Braunfels; Odessa; Orange; Palestine; Pampa; Paris; Pasadena; Pearland; Pearsall; Pecos; Perryton; Pharr; Pittsburg; Plainview; Plano; Pollok; Port Arthur; Port Lavaca; Presidio; Quitman; Raymondville; Refugio; Richardson; Richmond; Rio Grande City; Robstown; Rockwall; Rosenberg; Round Rock; Rowlett; Rusk; San Angelo; San Antonio; San Benito; San Juan; San Marcos; San Saba; Schertz; Seguin; Seminole; Seymour; Sherman; Silsbee; Sinton; Snyder; Socorro; Sonora; South Houston; Stephenville; Sugar Land; Sulphur Springs; Sweetwater; Taylor; Temple; Terrell; Texarkana; Texas City; The Woodlands; Tomball; Trinity; Tyler; Uvalde; Van Horn; Vernon; Victoria; Waco; Washington; Watauga; Waxahachie; Weatherford; Webster; Weslaco; Wharton; Wichita Falls; Woodville; Zapata

MOS Codes: No military equivalent (**Open to current AES/Eligibility Specialist Employees only)**

Are you a highly motivated, compassionate and dedicated individual looking for a rewarding career assisting the most vulnerable citizens of Texas in need of food, medical care, cash assistance and other social services? If so, the Texas Health and Human Services Commission (HHSC) Access and Eligibility Services (AES) division is looking for individuals who want to join an exciting, dynamic team working in a high-performing and innovative environment.

About the Role:

AES provides an integrated and streamlined approach to connect individuals to services and supports that: reduce institutionalization, allow individuals to remain in their communities, and promote economic and personal self-sufficiency. AES is built upon its' core values of respect, ownership, collaboration, and integrity with a goal of delivering best-in-class customer service to clients and stakeholders.

Responsibilities:

• Performs complex technical, administrative, and management work for a direct delivery unit.
• Completes unit reports, special narrative or statistical reports, and responds to complex high profile client complaints.
• Serves as a lead worker responsible for mentoring and training of new staff, which includes providing direction, support, and feedback.
• Serves as the acting supervisor in the unit supervisors absence.
• Performs case reviews to determine validity and accuracy of eligibility determinations made by other staff.
• Initiates, monitors, and manages service improvement projects and reports on activities.
• Interviews clients, verifies financial and other information, and determines/re-determines eligibility for SNAP (Food Stamps), Temporary Assistance for Needy Families (TANF), Medicaid and/or Medicaid for the Elderly and People with Disabilities (MEPD) programs.
• Completes formal reports and narratives for management.
• Provides general information and assistance to clients regarding programs and application process.
• Files Appeals, represents the agency in hearings and process hearing decisons.

Essential Job Functions (EJFs):

• Reviews case records to determine compliance with policies and procedures to identify trends and for corrective action.
• Assists in interpreting policy, training new workers, completing unit reports, and resolving and responding to customer complaints.
• Assists in support unit activities including case reading, troubleshooting, second level reviews, and On the Job Training assignments.
• Assists in developing standards or procedures for assigned areas.
• Interviews applicants and recipients in person or by inbound or outbound telephone calls to obtain pertinent financial and personal information to determine eligibility for public assistance programs.
• Evaluate data from various electronic and other sources to enter information into a computer-based eligibility system.
• Meet agency performance standards for case processing and benefit authorization.
• Process work in accordance with state and federal regulations and established procedures, guidelines and timeframes.
• Attends work on a regular and predictable schedule in accordance with agency leave policy.
• Performs other duties as assigned, including acting in the supervisor's absence.
• Must be able to work 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.

Knowledge, Skills and Abilities (KSAs):

• Knowledge of: Eligibility programs, requirements, and policies.
• Health Insurance Portability Accountability Act (HIPPA) and Tax Sensitive information regulations.
• Interviewing techniques to obtain personal information, make inquiries, and resolve conflicting statements.
• Skill in: Handling and resolving complex case issues.
• Use of automated data systems.
• Providing good customer service.
• Effective verbal and written communication.
• Ability to: Screen applications, verify eligibility criteria, and determine case dispositions.
• Present information to internal and external stakeholders.
• Interpret and apply agency, state, and federal rules, regulations, policy, and procedures.
• Develop and establish effective working relationships.
• Evaluate performance issues.
• Identify problems and evaluate alternatives.
• Work occasional overtime, as required by management, outside of normal hours of operation, which may include weekends when called upon.
• Work in a highly stressful and fast-paced environment, under constant pressure to meet required deadlines.

Registrations, Licensure Requirements or Certifications:

• N/A

Initial Screening Criteria:

• High School diploma or GED equivalent is required.
• Sixty (60) semester hours from an accredited college or university is required.
• Two (2) years of customer service experience may be substituted for required education.
• A minimum of five (5) years' recent experience as an Texas Works Eligibility Advisor and above is required.
• (Texas Works Advisor.)
• Experience in SNAP Medicaid and TANF, required
• Experience using manual and/or automated systems to determine eligibility for SNAP, TANF, and Texas Works Medicaid programs is required.
• Texas Integrated Eligibility Redesign System (TIERS) and Eligibility Workload Management System (EWMS) experience is preferred.
• Program Integrity Monitoring System experience preferred.
• Experience