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CAU Long Term Care Eligibility Specialist

Company: State of Louisiana
Location: Baton Rouge
Posted on: April 2, 2024

Job Description:

QualificationsPlease click HERE to apply.* Timely complete appeal actions to re-open and/or close cases in accordance with appeal status. Take precautions to not re-notice appellants when taking these actions.* Process CAU reversals which will include clearing issues and discrepancies in LaMEDS to assist with the processing of applications and renewals.* Review data systems to determine what action needs to be performed. Maintain controls to ensure reversals are completed within required deadlines.* Document eligibility research electronically in the required Medicaid system applications.* Prepare eligibility decision notices by inputting required data into the corresponding Medicaid application systems, as necessary.* Maintain knowledge of Medicaid policies and procedures and ensure that any new changes, updates or clearances are applied accordingly.* Maintain knowledge and usage of all verification systems the agency has access to.* Interpret and apply complex federal, state, and agency policy. Employ rudimentary knowledge and terminology of legal, medical and business areas, including real estate and insurance.* Trend and analyze appeals data both regionally and statewide. Develop and produce reporting based on appeals data to influence training needs and decision making.* Attend and participate in required meetings and trainings.* Attend LTC hearings when needed.* Complete LTC appeal packets needed.* Other tasks as directed.QUALIFICATIONSREQUIRED:* Bachelor's degree or 6 years of professional experience in lieu of degree.* Minimum two years of professional experience determining Medicaid eligibility.* Minimum one year of professional experience determining Long Term Care and Waiver eligibility.* Minimum one year of professional experience utilizing the LaMEDS system.* Excellent analytical skills, effective organizational and time management skills.* Great attention to detail and follow up.* Excellent verbal and written communication skills.DESIRED:* Advanced degree.* Minimum three years of professional experience in determining Medicaid eligibility.* Minimum two years of professional experience in determining Long Term Care and Waiver Medicaid eligibility* Minimum two years of professional experience working with Medicaid appeals process.* Minimum two years of professional experience utilizing the LaMEDS system.

Keywords: State of Louisiana, Baton Rouge , CAU Long Term Care Eligibility Specialist, Other , Baton Rouge, Louisiana

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