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:
Work Location: In person
