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Claims Recovery Specialist

Claims Recovery Specialist

Iowa StaffingCoralville, IA, US
20 hours ago
Job type
  • Full-time
Job description

Claims Recovery Specialist

Iowa Department of Health and Human Services (HHS, Division of Community Access, Eligibility Determinations, Integrated Claims Recovery Unit, is seeking a Claims Recovery Specialist (Income Maintenance Worker 2) to support program integrity and provide ongoing cost savings and cost avoidance through eliminating duplicate assistance and establishing overpayment claims for Medicaid, Supplemental Nutrition Assistance Program (SNAP) and FIP. This position is part of a small unit and is one of 12 workers reviewing potential benefit overpayments, determining correct benefit eligibility, and establishing claims. This is a full-time opportunity, Monday Friday with typical hours being from 8 : 00 AM - 4 : 30 PM with overtime as needed. This position currently has the option to work from their home.

Core Essential Functions :

  • Analyze and interpret complex policies and procedures per state and federal regulations.
  • Collect and analyze information from customers and 3rd parties to calculate and determine eligibility.
  • Communicate effectively via phone, email and in person as needed.
  • Meet daily and monthly processing timeframes.
  • Prepare written documents and can clearly present, both in writing and orally.
  • Effectively manage an individual workload while working within a team.
  • Maintain high attendance.
  • Demonstrate excellent organizational and critical thinking skills.
  • Comply with all State of Iowa regulations and DHS Employee Handbook work rules.

Some specific goals of this position include :

  • Determining eligibility and appropriate benefit amounts and stopping incorrect benefit disbursements.
  • Providing consistency and accuracy of claims establishment thus improving Appeals outcomes.
  • Responding to inquiries regarding overpayments.
  • Establishing and working Intentional Program Violations (IPV), including a heavy volume of testifying at : depositions and hearings, both criminal and administrative.
  • The ideal candidate will have :

  • Excellent case plan development and critical thinking.
  • Strong communication and customer service.
  • Professional presence and strong work ethic.
  • Solid teamwork and consultation.
  • Appeals experience is required. Preference will be given for experience in Public Assistance programs. I.e.. Food Assistance, Family Investment Program, and Medicaid.
  • This position requires successful completion of a criminal background check to include FBI fingerprinting prior to beginning employment.

    How to Apply :

    For help creating a profile or entering your information, please go to the online Employment Application Guide. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

    Benefits

    Working for the State of Iowa comes with its perks. In addition to a competitive salary, you'll enjoy a comprehensive benefits package designed to support your well-being and professional growth :

    Health, Dental, and Vision Coverage : Health and dental insurance packages to keep you and your family healthy at a low cost with outstanding coverage!

    Paid Time Off : Take time to recharge with paid time off, including vacation (96 hours / year to begin, increasing with years of service), sick leave (144 hours / year), and paid holidays (9 days / year).

    Retirement Plans : Participate in retirement plans such as IPERS (employees contribute 6.29% and the State of Iowa contributes 9.44%) as well as our Retirement Investors Club (RIC), Employer Sponsored Retirement Plan (the State of Iowa matches dollar for dollar up to $75 / month).

    Flexible Spending Accounts : Take advantage of flexible spending accounts for medical and dependent care expenses.

    Insurance Coverage : Benefit from life insurance and free long-term disability insurance for added peace of mind.

    Employee Assistance Program : Access resources and support through our Employee Assistance Program for personal and professional challenges.

    Employee Discount Programs : Enjoy discounts on a variety of goods and services through our employee discount programs.

    Minimum Qualification Requirements

    Sixty semester hours (or equivalent academic units) from an accredited college or university; OR a combination of education and experience substituting the equivalent of one year of full-time public contact work experience obtaining, analyzing and / or evaluating data for each year of the required college education (on the basis that thirty semester hours is equal to one year of work experience); OR employees with current continuous experience in the state executive branch that includes experience equal to 18 months of full-time work at a Clerk Advanced level or above involving public contact experience on a regular basis in a service area.

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