Medicaid Analyst 1-3 (Region 9 Tangipahoa)

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

Zusammenfassung

The Louisiana Department of Health is seeking a Medicaid Analyst to determine eligibility for health insurance programs and to provide accurate, timely assistance to applicants via multiple channels, including phone, mail, and online submissions.

The ideal candidate will be detail-oriented, customer-service focused, and able to navigate web-based programs, comply with policies, and work effectively in a high-volume call center environment in Region 9 / Tangipahoa Parish.

Qualifikationen

• 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 counts as one year of experience toward the six years.
• Conduct interviews with clients and verifies information for eligibility.
• Ability to determine level of benefits and apply complex policies to programs.

Aufgaben

• Acquire knowledge of Medicaid policy and procedures to determine eligibility.
• Determine eligibility for health insurance for members and applicants via multiple channels.
• Conduct interviews with clients and verify information for eligibility determinations.
• Apply complex federal, state, and agency policies to each program.
• Counsel and refer potentially eligible recipients to other agencies.

Kenntnisse

Communicating Effectively

Accountability

Policy Compliance

Customer Service

Deadline-Oriented

Ausbildung

Bachelor's degree

Jobbeschreibung

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 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 of web-based programs. Work conditions are a combination of sedentary work on a computer, 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, computer literate, is a team player, and 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
• 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 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 complies 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 Filed Operations - Region 9 / Tangipahoa 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: 3052050410

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.