Medicaid Analyst 1-3 (Region 7 Caddo)

Grambling State University; Shreveport (LA); On-site; USD 23,000 - 29,000; Full time

Job summary

The Medicaid Analyst (MA) position with the Louisiana Department of Health focuses on acquiring extensive knowledge of Medicaid policy and procedures to determine timely and accurate eligibility for health insurance. Work involves multiple application channels (electronic, mail, email, in person, phone) within a call-center environment.

The ideal candidate demonstrates strong customer service, attention to deadlines, and experience with high call volumes, with growth potential within the state

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.
• Ability to handle high call volumes and work in a Call-Center format.

Responsibilities

• Acquires extensive knowledge of Medicaid policy and procedures to determine eligibility for health insurance.
• Determines eligibility for health insurance for members and applicants via electronic, mail, email, in person, or phone applications.
• Conducts interviews with clients and collects verification to determine eligibility for Medicaid programs.
• Makes decisions on complex eligibility factors and applies federal/state policies per program.
• Conducts investigations and compliance reports concerning fraud and refers eligible recipients or applicants to other agencies.

Skills

Communicating Effectively

Demonstrating Accountability

Following Policies and Procedures

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.

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:

• 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.

Information on the 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.