Medicaid Analyst 1-3 (Region 5 Calcasieu)

State of Louisiana•Lake Charles, LA

1d•Onsite

About The Position

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 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 policies.

Requirements

Three years of social services experience; OR Six years of full-time experience in any field; OR A bachelor's degree.
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.
Competency of web-based programs.
Works independently.
Detail-oriented.
Excellent customer service skills.
Can perform routine activities.
Attentive to deadlines.
Computer literate.
Team player.
Experience with high call volumes.
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.

Responsibilities

Acquiring an extensive knowledge of Medicaid policy and procedures.
Making timely and accurate Medicaid eligibility determinations.
Determining eligibility for health insurance to members and applicants.
Receiving applications electronically by computer, by mail, by email, in person, or by telephone.
Conducting interviews with clients and making other necessary collateral contacts for verification in determining eligibility for Medicaid Programs.
Examining application packets for timelines, completeness, and appropriateness prior to authorization of reimbursements.
Making decisions on complex eligibility factors and determining level of benefits for federal and state funded programs as a result of the roll down procedure.
Interpreting and applying complex federal, state, and agency policies for each program.
Conducting special investigations and compiling reports concerning fraud and location of absent parents.
Counselling and referring potentially eligible recipients or applicants to other agencies.