Medicaid Analyst
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 :
- Focusing on Customers : The ability to serve the needs of those who support and / or rely on the services provided.
- Following Policies and Procedures : The ability to comply with policies and procedures of the organization as well as State Civil Service rules, and all applicable federal and state laws.
- Thinking Critically : The ability to objectively question, analyze, interpret, and evaluate information to form a conclusion.
- Adapting to Change : The ability to adjust plans, expectations, and behaviors in response to change.
Minimum Qualifications :
Three years of social services experience; ORSix years of full-time experience in any field; ORA bachelor's degree.Experience substitution : 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.
Job Duties :
Under close supervision, the entry level Medicaid Analyst learns to perform the following duties :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.Medicaid eligibility is fundamental to the overall Medicaid program, and the mastery of eligibility policy and procedure may be the first step in a path for career growth in health insurance field.Conducts interviews with clients and makes other necessary collateral contacts for verification in determining eligibility for Medicaid Programs. Examines application packets for timelines, completeness, and appropriateness prior to authorization of reimbursements.Makes decisions on complex eligibility factors and determines level of benefits for federal and state funded programs as a result of the roll down procedure. Interprets and applies complex federal, state, and agency policies for each program.Conducts special investigations and complies reports concerning fraud and location of absent parents. Counsels and refers potentially eligible recipients or applicants to other agencies.Position-Specific Details :
Location : Medical Vendor Administration / Medicaid Region 6 / Calcasieu ParishAppointment Type : This position may be filled as a Probationary or Promotional appointment.Cost Center : 3052050407Position Number(s) : 50593044, 157433Career Progression : This position may be filled as a Medicaid Analyst 1, 2, or 3 determined by the qualifications of the candidate selected. This position provides the opportunity to advance within this job series.Compensation : This position is eligible for the following Special Entrance Rates (SER), as well as a Premium Pay of up to $2.00 / hr for hours worked based on longevity.Medicaid Analyst 1 - $16.42 hr / $1,313.60 bi-weeklyMedicaid Analyst 2 - $17.56 hr / $1,404.80 bi-weeklyMedicaid Analyst 3 - $21.27 hr / $1,701.60 bi-weeklyHow To Apply :
No Civil Service test score is required in order to be considered for this vacancy. To apply for this vacancy, click on the "Apply" link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.
Information to support your eligibility for the position must be included in the application (i.e., relevant, detailed experience / education). Resumes will not be accepted in lieu of completed education and experience sections. Applications may be rejected if incomplete.Contact Information :
Paul Tran
paul.tran3@la.gov
LA Department of Health (LDH) Division of Human Resources PO Box 4818 Baton Rouge, LA 70821
225-342-6477
This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218.
LDH supports Louisiana's commitment to being a State as a Model Employer (SAME) by promoting the recruitment, hiring, and retention of individuals with disabilities. Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity to make a difference through public service. With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career.
As a state employee, you will earn competitive pay, choose from a variety of benefits, and have access to a great professional development program :
Insurance CoverageParental Leave Up to six weeks paid parental leaveHolidays and Leave State employees receive the following paid holidays each year : New Year's Day, Martin Luther King, Jr. Day, Mardi Gras, Good Friday, Memorial Day, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day and Christmas Day. Additional holidays may be proclaimed by the Governor.State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.Retirement State of Louisiana employees are eligible to participate in various retirement systems (based on the type of appointment and agency for which an employee works). These retirement systems provide retirement allowances and other benefits for state officers and employees and their beneficiaries. State retirement systems may include (but are not limited to) : Louisiana State Employees Retirement System (www.lasersonline.org), Teacher's Retirement System of Louisiana (www.trsl.org), Louisiana School Employees Retirement System (www.lsers.net), among others.