Medicaid Analyst 1-3 (Region 7 Caddo)

State of Louisiana; Shreveport (LA); Vor Ort; USD 34.000 - 44.000; Vollzeit

Zusammenfassung

Louisiana Department of Health seeks a Medicaid Analyst to acquire extensive knowledge of Medicaid policy and procedures and to use the tools to make timely, accurate Medicaid eligibility determinations. The MA determines health insurance eligibility for members and applicants through electronic, mail, email, in person, or phone applications.

The ideal candidate will be detail-oriented, with excellent customer service skills, capable of handling high call volumes, and comfortable working in a

Qualifikationen

• Three years of social services experience; OR six years of full-time experience in any field; OR a bachelor's degree.

Aufgaben

• The Medicaid Analyst (MA) learns Medicaid policy and procedures to make timely, accurate eligibility determinations.
• Determines health insurance eligibility for members and applicants via various application channels.
• Maintains mastery of eligibility policy and procedures for career growth in the health insurance field.
• Conducts client interviews and collateral contacts for verification of eligibility.
• Makes decisions on complex eligibility factors and applies federal, state, and agency policies.
• Conducts investigations and compliance reports concerning fraud and location of absent parents; counsels potentially eligible recipients.

Kenntnisse

Social services experience

Customer service

Detail oriented

Call handling

Ausbildung

Bachelor's degree

Jobbeschreibung

About This Job

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.

Minimum Qualifications

• 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.

Job Specification

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

Job 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 the 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 7 / Caddo Parish

Appointment Type: This position may be filled as a Probationary appointment, Promotional appointment, Job appointment (temporary appointment that may last up to 48 months)

Cost Center: 3052050408

Position Number(s): Multiple

Career Progression: This position may be filled as a Medicaid Analyst 1, 2, or 3 determined by the qualifications of the candidate selected. This position provides the opportunity to advance within this job series.

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

Casey Hickman

[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.

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.

Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity to make a difference through public service. With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career.

Insurance Coverage

More information can be found at https://info.groupbenefits.org/

Parental Leave

- Up to six weeks paid parental leave

More information can be found at https://www.civilservice.louisiana.gov/Parental-Leave/Default.aspx

Holidays and Leave

- State employees receive the following paid holidays each year:

• New Year's Day
• Martin Luther King, Jr. Day
• Mardi Gras
• Good Friday
• Memorial Day
• Independence Day
• Labor Day
• Veteran's Day
• Thanksgiving Day and Christmas Day
• Additional holidays may be proclaimed by the Governor

State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.

Retirement

- State Of Louisiana Employees Are Eligible To Participate In Various Retirement Systems (based On The Type Of Appointment And Agency For Which An Employee Works). These Retirement Systems Provide Retirement Allowances And Other Benefits For State Officers And Employees And Their Beneficiaries. State Retirement Systems May Include (but Are Not Limited To):

• Louisiana State Employees Retirement System (www.lasersonline.org). LASERS has provided this video to give you more detailed information about their system
• Teacher's Retirement System of Louisiana (www.trsl.org)
• Louisiana School Employees Retirement System (www.lsers.net), among others