Key Responsibilities:

Ability to maintain a high-volume caseload and adhere to the timeliness standard of appeals while conducting the due process review.
Assist in the achievement of a high performing and positive work environment that will promote the TennCare Mission.
Daily receives and reviews appeals for potential resolution within policy guidelines. If a resolution cannot be found, make outreach.
Conduct outreach to explain the state's actions related to TennCare Medicaid programs and coordinate with other staff for the prompt resolution of appeals where necessary.
Demonstrates attention to detail in researching appeal cases and documenting notes for proper case processing. Attends and actively participates in all unit meetings and problem-solving discussions for workflow improvements. Ability to navigate TEDS.

Minimum Qualifications:
Education and Experience: Graduation from an accredited college or university with a bachelor's degree in a related field (preferred degree in business administration, management, public health, health policy, paralegal, or legal assistant studies) and 2 years of relevant work experience. OR an equivalent combination of education and work experience may be considered.

Ability to foster and maintain cohesive working relationships
Ability to adapt to changing priorities and deadlines
Ability to exercise sound judgment
Strong organizational skills necessary, including the ability to prioritize, multi-task and manage workload to meet specific time frames and deadlines
Advanced writing and communication skills

Job Type: Contract

Schedule:

8 hour shift

Work Location: In person

Anveta Health Inc

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