Medicaid/Medicare Services Specialist I
About The Position
The Department for Medicaid Services (DMS) provides health care access for eligible low-income residents of Kentucky including children, families, pregnant women, the aged and the disabled as well as a number of programs and services directed at specific eligibility and medical needs. DMS strives each day to meet the mission of the Cabinet for Health and Family Services to be a diverse and inclusive organization providing programs, services and supports that protect and promote the health and well-being of all Kentuckians and their communities. Join the Department for Medicaid Services (DMS) — where our team works together to ensure compliance, strengthen oversight, and support quality healthcare access for Kentuckians across the Commonwealth. Learn more about us at: https://chfs.ky.gov/agencies/dms/pages/default.aspx
Requirements
- Graduate of a college or university with a bachelor's degree.
- NONE
Nice To Haves
- Prior Medicaid knowledge and/or experience
- Microsoft program knowledge
- SharePoint program knowledge
- Organizational skill
- Public speaking skill
- Written and verbal communication skills
Responsibilities
- Interpreting State and Federal Regulations
- Responding to inquiries relating to 907 KAR 17:035 External Independent Third-Party Review
- Rendering a determination on eligibility of case reviews to the State’s contracted vendor
- Monitoring compliance of the vendors contractual requirements
- Monitoring program to ensure efficiency and production service level agreements are met
- Managing tracking system and appropriately follow all guidance and standard operating procedures set forth.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Number of Employees
1,001-5,000 employees
