Medicaid Recovery Caseworker (Executive I)

State of Illinois•Springfield, IL

10d

About The Position

The Illinois Department of Healthcare and Family Services, Division of Finance, Bureau of Collection Services is seeking to hire a Medical Recovery Caseworker responsible for reviewing and implementing policies and procedures to recover amounts owed to the State Medicaid program. This position consult with external attorneys, representatives from the Attorney General’s Office, Circuit Clerk offices, third-party payers, and others to determine the status of cases and legal proceedings. The caseworker will also initiate and monitor the referral of all case documentation to the Attorney General’s Office for assistance with recovery efforts; review documentation and corresponds with attorneys, insurance companies, and Department of Human Services (DHS) local offices regarding recoveries of cases; confer with management and recommend the resolution of claims based on the facts and circumstances of each case; and compile and develop periodic statistical and financial reports as directed by management to monitor case progress and assess completion of tasks and goals. HFS values employees with different backgrounds, life experiences, and talents.

Requirements

Requires knowledge skill and mental development equivalent to completion of four (4) years of college, preferably with coursework in business or public administration
Requires one (1) year of responsible administrative experience in a public or business organization, or completion of an agency approved professional management training program
Requires completion of a background check and self-disclosure of criminal history
Requires the ability to utilize and maintain state issued equipment such as a laptop

Nice To Haves

One (1) year of experience researching and analyzing medical/case records related to casualty, Workers’ Compensation or estate recovery cases
One (1) year of experience negotiating case settlements with insurance carriers, attorneys, or similar entities
One (1) year of experience utilizing medical systems such as: Medical Management Information Systems (MMIS), Integrated Eligibility Systems (IES), Enterprise Data Warehouse (EDW), or Medical Expenditure Reporting and Analysis (MERA)
One (1) year of experience in medical case management
One (1) year of experience utilizing Microsoft Excel, Word, and Outlook

Responsibilities

Serves as a Medicaid Recovery Caseworker for the Illinois Department of Healthcare and Family Services (HFS), Division of Finance, Bureau of Collection Services by reviewing and implementing policies and procedures to recover amounts owed to the State Medicaid program
Consults with external attorneys, representatives from the Attorney General’s Office, Circuit Clerk offices, thirdparty payers, and others to determine the status of cases and legal proceedings
Initiates and monitors the referral of all case documentation to the Attorney General’s Office for assistance with recovery efforts
Reviews documentation and corresponds with attorneys, insurance companies, and Department of Human Services (DHS) local offices regarding recoveries of cases
Confers with management and recommends the resolution of claims based on the facts and circumstances of each case
Compiles and develops periodic statistical and financial reports as directed by management to monitor case progress and assess completion of tasks and goals
Participates in special projects and collaborative work groups
Performs other duties as required or assigned which are reasonably within the scope of the duties enumerated above

Benefits

Monday-Friday work schedule
Flexible work schedules are available in many program areas.
Health, Life, Vision, and Dental Insurance
Pension Plan
Paid Parental Leave
Deferred Employees Compensation Program and other pre-tax benefit programs (Medical/Daycare)
Employees earn (12) paid Sick Days annually.
New Employees earn (10) paid Vacation Days their first year of service and can earn up to (25) paid Vacation Days annually.
Employees earn (3) paid Personal Days annually.
(13-14) paid holidays annually (based on start date)