Job Summary

Job Description

• Timely complete appeal actions to re-open and/or close cases in accordance with appeal status. Take precautions to not re-notice appellants when taking these actions.
• Process CAU reversals which will include clearing issues and discrepancies in LaMEDS to assist with the processing of applications and renewals.
• Review data systems to determine what action needs to be performed. Maintain controls to ensure reversals are completed within required deadlines.
• Document eligibility research electronically in the required Medicaid system applications.
• Prepare eligibility decision notices by inputting required data into the corresponding Medicaid application systems, as necessary.
• Maintain knowledge of Medicaid policies and procedures and ensure that any new changes, updates or clearances are applied accordingly.
• Maintain knowledge and usage of all verification systems the agency has access to.
• Interpret and apply complex federal, state, and agency policy. Employ rudimentary knowledge and terminology of legal, medical and business areas, including real estate and insurance.
• Trend and analyze appeals data both regionally and statewide. Develop and produce reporting based on appeals data to influence training needs and decision making.
• Attend and participate in required meetings and trainings.
• Other tasks as directed.

QUALIFICATIONS

REQUIRED:

• Bachelor’s degree or 6 years of professional experience in lieu of degree.
• 2 years of professional experience determining Medicaid eligibility.
• Current working knowledge of the LaMEDS system.
• Excellent analytical skills, effective organizational and time management skills.
• Great attention to detail and follow up.
• Excellent verbal and written communication skills.

DESIRED:

• Advanced degree.
• Minimum 4 years of professional experience in determining Medicaid eligibility.
• Minimum 2 years of professional experience working with Medicaid appeals process.
• Advanced knowledge of the LaMEDS system.
• Experience with data analysis and research.

Required Attachments Please upload the following documents in the Resume/Cover Letter section.

• Detailed resume listing relevant qualifications and experience;
• Cover Letter indicating why you are a good fit for the position and University of Louisiana Systems;
• Names and contact information of three references; Applications that do not include the required uploaded documents may not be considered.

Posting Close Date

This position will remain open until filled. Note to Applicant: Applicants should fully describe their qualifications and experience with specific reference to each of the minimum and preferred qualifications in their cover letter. The search committee will use this information during the initial review of application materials. References will be contacted at the appropriate phase of the recruitment process. This position may require a criminal background check to be conducted on the candidate(s) selected for hire. As part of the hiring process, applicants for positions at the University of New Orleans may be required to demonstrate the ability to perform job-related tasks. The University of New Orleans is an Affirmative Action and Equal Employment Opportunity employer. We do not discriminate on the basis of race, gender, color, religion, national origin, disability, sexual orientation, gender identity, protected Veteran status, age if 40 or older, or any other characteristic protected by federal, state, or local law.