The Eligibility Specialist has primary responsibility for providing the information necessary to resolve complaints received from the claimant, his/her representative or other concerned persons.
The Eligibility Specialist may receive the complaint directly. The Eligibility Specialist may be able to resolve the problem immediately through discussion with the complainant. If the Eligibility Specialist resolves the problem the fact that a complaint was made and the nature of the complaint should be discussed with the immediate supervisor. If the Eligibility Specialist cannot satisfy the complainant immediately, the complaint should be discussed with the immediate supervisor before any action is taken.
Each complaint should be reviewed by the person who receives the complaint and routed through the first line supervisor to the Eligibility Specialist responsible for the case. The Eligibility Specialist, in consultation with his/her immediate supervisor, will decide what action is necessary and will take that action. This decision should then be routed back to the person who received the complaint. It is this person’s responsibility to reply to the complainant.