Appeals Coordinator
About The Position
Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day. As an Appeals Coordinator you will represent the customer, the Louisiana Department of Health (LDH) Office of Aging and Adult Services (OAAS), in defending eligibility decisions by appearing before the Division of Administrative Law (DAL) in appeal hearings with presentations of summaries of evidence. In this remote role, you will: Review decision/denial letters on new appeals requests received, research data and materials to accumulate evidence, draft and prepare summary of evidence (SOE) files, upload final SOE files to the DAL SharePoint site. Monitor deadlines to ensure timely submission of SOE files and hearing status reports. Collaborate with internal departments as needed to gather information needed to complete appeal file. Participate in quality assurance (QA) process of Long Term-Personal Care Services (LT-PCS) eligibility decision. Conduct appeals hearing over the phone with division of administrative law.
Requirements
- Have a bachelor’s degree in health and human services, social work, sociology, psychology, or a related field.
- Demonstrate quality communication skills, both oral and written.
- Show a desire to work with the public.
- Be a Louisiana resident.
Nice To Haves
- Have experience in health-related social and/or human services.
- Have experience working with older adults or individuals with disabilities.
Responsibilities
- Review decision/denial letters on new appeals requests received
- Research data and materials to accumulate evidence
- Draft and prepare summary of evidence (SOE) files
- Upload final SOE files to the DAL SharePoint site
- Monitor deadlines to ensure timely submission of SOE files and hearing status reports
- Collaborate with internal departments as needed to gather information needed to complete appeal file
- Participate in quality assurance (QA) process of Long Term-Personal Care Services (LT-PCS) eligibility decision
- Conduct appeals hearing over the phone with division of administrative law
Benefits
- Health and Welfare Benefits
- Retirement Savings
- Employee Discounts
- Career Growth Opportunities
- Paid Training
- Paid time off
- health insurance coverage
- voluntary dental and vision programs
- life and disability insurance
- a retirement savings plan
- paid holidays
- paid time off (PTO) or vacation and/or sick time
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
