MEDICAID ANALYST 1-3 (Region 3 Lafourche)

State of Louisiana; Thibodaux (LA); On-site; USD 34,000 - 44,000; Full time

Benefits offered by this job

SER

Premium Pay up to $2.00/hr for hours—|

Job summary

The Louisiana Department of Health seeks a Medicaid Analyst to acquire extensive knowledge of Medicaid policy and procedures and to use the same tools to make timely and accurate eligibility determinations. The role involves determining health insurance eligibility for members and applicants through electronic, mail, email, in person, or telephone channels.

Ideal candidates will have experience with web-based programs, excel in a call-center setting, and demonstrate strong customer service

Qualifications

• Three years of social services experience, OR six years of full-time experience in any field, OR a bachelor's degree.
• Experience with high call volumes and call-center environments.
• Competency with web-based programs and computer literacy.
• Ability to work independently and meet deadlines.

Responsibilities

• Learn and apply Medicaid policy to determine eligibility.
• Determine eligibility for health insurance for members and applicants via multiple channels.
• Interview clients and verify information for eligibility.
• Interpret complex policies and apply rules to program benefits.
• Support compliance and referrals to other agencies.

Skills

Communicating effectively

Demonstrating accountability

Following policies and procedures

Customer service

Education

Bachelor's degree

Job description

The mission of the Louisiana Department of Health is to protect and promote health and to ensure access to medical, preventive, and rehabilitative services for all residents of the State of Louisiana.

Learn more about the Louisiana Department of Health

The Medicaid Analyst (MA) is a position responsible for acquiring an extensive knowledge of Medicaid policy and procedures, and using the same tools to make timely and accurate Medicaid eligibility determinations.

The MA determines eligibility for health insurance to members and applicants in the manner of their choosing. The applications are received electronically by computer, by mail, by email, in person, or most often by telephone. This position requires competency with web-based programs. Work conditions are a combination of sedentary work on a computer and helping members by phone in a Call-Center format. The successful candidate is an individual who works independently, is detail-oriented, has excellent customer service skills, can perform routine activities, is attentive to deadlines, is computer literate, is a team player, and has experience with high call volumes. Medicaid eligibility is fundamental to the overall Medicaid program, and mastery of eligibility policy and procedure may be the first step in a path for career growth in the health insurance field.

An ideal candidate should possess the following competencies:

• Communicating Effectively: The ability to convey information, ideas, and emotions using structured communication methods that promote understanding and engagement.
• Demonstrating Accountability: The ability to take ownership of actions, behaviors, performance, decisions, and outcomes.
• Following Policies and Procedures: The ability to follow, reinforce, adapt, or develop policies and procedures to maintain compliance with federal and state legal requirements, State Civil Service rules, and organizational policies.
• Three years of social services experience; OR
• Six years of full-time experience in any field; OR
• A bachelor's degree.
• EXPERIENCE SUBSTITUTION: Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.

The official job specifications for this role, as defined by the State Civil Service, can be found here.

Job Duties:

Under close supervision, the entry level Medicaid Analyst learns to perform the following duties:

• The Medicaid Analyst (MA) is a position responsible for acquiring an extensive knowledge of Medicaid policy and procedures, and using the same tools to make timely and accurate Medicaid eligibility determinations.
• The MA determines eligibility for health insurance to members and applicants in the manner of their choosing. The applications are received electronically by computer, by mail, by email, in person, or most often by telephone.
• Medicaid eligibility is fundamental to the overall Medicaid program, and the mastery of eligibility policy and procedure may be the first step in a path for career growth in health insurance field.
• Conducts interviews with clients and makes other necessary collateral contacts for verification in determining eligibility for Medicaid Programs. Examines application packets for timelines, completeness, and appropriateness prior to authorization of reimbursements.
• Makes decisions on complex eligibility factors and determines level of benefits for federal and state funded programs as a result of the roll down procedure. Interprets and applies complex federal, state, and agency policies for each program.
• Conducts special investigations and compliance reports concerning fraud and location of absent parents. Counsels and refers potentially eligible recipients or applicants to other agencies.

Position-Specific Details:

Location: Medical Vendor Administration / Eligibility Field Operations - Region 3 / Lafourche Parish

Appointment Type: Probational, Promotional or Job Appointment (temporary appointment that may last up to 48 months)

Cost Center: 305-2050404

Position Number(s): Multiple

Career Progression: This position may be filled as a Medicaid Analyst 1, 2, or 3, depending on the qualifications of the selected applicant.

Compensation:This position is eligible for the following Special Entrance Rates (SER), as well as a Premium Pay of up to $2.00/hr for hours worked based on longevity.

Medicaid Analyst 1 - $16.42 hr / $1,313.60 bi-weekly
Medicaid Analyst 2 - $17.56 hr / $1,404.80 bi-weekly
Medicaid Analyst 3 - $21.27 hr / $1,701.60 bi-weekly

Contact Information:

[e-mail]

LA Department of Health (LDH)

Division of Human Resources

PO Box 4818

Baton Rouge, LA 70821

225-342-6477

This organization participates in E-Verify, and for more information on E-Verify, please contact DHS at 1-888-464-4218.

LDH supports Louisiana's commitment to being a State as a Model Employer (SAME) by promoting the recruitment, hiring, and retention of individuals with disabilities.

Information on Louisiana Works, Louisiana Rehabilitation Services is available here.

LDH is an equal opportunity employer and seeks to recruit a highly productive and diverse workforce and will provide equal employment opportunities to all employees and prospective employees. Employment decisions shall be based strictly on merit and without regard to religious or political beliefs, sex, race, or any other non-merit factor.