The University of New Orleans
Thank you for your interest in The University of New Orleans.
Once you start the application process, you will not be able to save your work, so you should collect all required information before you begin. The required information is listed below in the job posting.
You must complete all required portions of the application and attach the required documents in order to be considered for employment.
Department MMIS Operations
Job Summary
Job Description
Serves as the subject matter expert in Third-Party Liability (TPL) Recovery issues related to Estate, Trauma, Special Needs Trusts, and/or restitution recoveries. Provides support for and may send responses to escalated matters. Maintains an advanced working knowledge of Medicaid and Eligibility policy to interpret Medicaid claims. Participates in the development and implementation of TPL policies and procedural changes related to Estate, Trauma, Special Needs Trusts, and/or restitution recoveries. Performs advanced research of claims to identify claims associated with accident-related diagnoses and treatments and/or applicable to various recovery types. Performs advanced calculations to determine appropriate claims recovery amounts and processes incoming payments. Provides support to the Medicaid Fraud and Recovery Investigative Unit's ongoing, statewide operational activities relative to restitution and fraud recoveries. Pursues the recovery of funds from third parties (including the estates and Trusts of deceased recipients), as appropriate and according to established policies and procedures; includes issuance of recovery notices and assistance to LDH's Bureau of Legal Service when defending LDH's interest in legal proceedings. May conduct extensive asset, estate, succession, claim, and other necessary case research, potentially involving escalated matters. Requires regular coordination with LDH's Bureau of Legal Service, families of deceased Medicaid recipients, attorneys, insurance companies, and other third parties, in the regular management of assigned Recovery caseload and general recovery matters, potentially including escalations. Serves as the LDH representative for recovery matters under appeal, including preparation of Summaries of Evidence and other documentation and processes required of the LDH's and Department of Administrative Law's fair hearing processes. Makes recommendations for system changes required due to changing federal and/or state regulations, Medicaid policies, and other factors including system modernization efforts. May lead the planning, development, design, testing, and implementation of changes and/or new specifications to the recovery system. May serve as backup to management (i.e. Medicaid Program Supervisor, Medicaid Program Manager 1B). Other tasks as assigned. QUALIFICATIONS REQUIRED:
Bachelor's degree, or Associate's degree plus 3 years of professional experience, or 6 years of professional work experience. Minimum 1 year professional experience with Medicaid Long Term Care and Home and Community Based Service (HCBS) programs. Excellent analytical skills, effective organizational and time management skills. Ability to manage projects, assignments, and competing priorities. Proficient in the use of Microsoft Office, including but not limited to Outlook, Word, and Excel. Great attention to detail and follow up, and verbal/written communications skills.
DESIRED:
Advanced degree. Minimum 2 years professional experience with Medicaid Long Term Care and HCBS programs. Minimum 2 years professional experience with Louisiana Medicaid systems and policy. Minimum 2 years professional experience with liability insurance claims processing. Minimum 1 year professional experience with CPT, ICD-9 or ICD-10 coding, and/or HCPCS. Required Attachments
Please upload the following documents in the Resume/Cover Letter section.
Detailed resume listing relevant qualifications and experience; Cover Letter indicating why you are a good fit for the position and University of Louisiana Systems; Names and contact information of three references;
Applications that do not include the required uploaded documents may not be considered.
Posting Close Date This position will remain open until filled.
Note to Applicant:
Applicants should fully describe their qualifications and experience with specific reference to each of the minimum and preferred qualifications in their cover letter. The search committee will use this information during the initial review of application materials.
References will be contacted at the appropriate phase of the recruitment process.
This position may require a criminal background check to be conducted on the candidate(s) selected for hire.
As part of the hiring process, applicants for positions at the University of New Orleans may be required to demonstrate the ability to perform job-related tasks.
The University of New Orleans is an Affirmative Action and Equal Employment Opportunity employer. We do not discriminate on the basis of race, gender, color, religion, national origin, disability, sexual orientation, gender identity, protected Veteran status, age if 40 or older, or any other characteristic protected by federal, state, or local law.
Once you start the application process, you will not be able to save your work, so you should collect all required information before you begin. The required information is listed below in the job posting.
You must complete all required portions of the application and attach the required documents in order to be considered for employment.
Department MMIS Operations
Job Summary
Job Description
Serves as the subject matter expert in Third-Party Liability (TPL) Recovery issues related to Estate, Trauma, Special Needs Trusts, and/or restitution recoveries. Provides support for and may send responses to escalated matters. Maintains an advanced working knowledge of Medicaid and Eligibility policy to interpret Medicaid claims. Participates in the development and implementation of TPL policies and procedural changes related to Estate, Trauma, Special Needs Trusts, and/or restitution recoveries. Performs advanced research of claims to identify claims associated with accident-related diagnoses and treatments and/or applicable to various recovery types. Performs advanced calculations to determine appropriate claims recovery amounts and processes incoming payments. Provides support to the Medicaid Fraud and Recovery Investigative Unit's ongoing, statewide operational activities relative to restitution and fraud recoveries. Pursues the recovery of funds from third parties (including the estates and Trusts of deceased recipients), as appropriate and according to established policies and procedures; includes issuance of recovery notices and assistance to LDH's Bureau of Legal Service when defending LDH's interest in legal proceedings. May conduct extensive asset, estate, succession, claim, and other necessary case research, potentially involving escalated matters. Requires regular coordination with LDH's Bureau of Legal Service, families of deceased Medicaid recipients, attorneys, insurance companies, and other third parties, in the regular management of assigned Recovery caseload and general recovery matters, potentially including escalations. Serves as the LDH representative for recovery matters under appeal, including preparation of Summaries of Evidence and other documentation and processes required of the LDH's and Department of Administrative Law's fair hearing processes. Makes recommendations for system changes required due to changing federal and/or state regulations, Medicaid policies, and other factors including system modernization efforts. May lead the planning, development, design, testing, and implementation of changes and/or new specifications to the recovery system. May serve as backup to management (i.e. Medicaid Program Supervisor, Medicaid Program Manager 1B). Other tasks as assigned. QUALIFICATIONS REQUIRED:
Bachelor's degree, or Associate's degree plus 3 years of professional experience, or 6 years of professional work experience. Minimum 1 year professional experience with Medicaid Long Term Care and Home and Community Based Service (HCBS) programs. Excellent analytical skills, effective organizational and time management skills. Ability to manage projects, assignments, and competing priorities. Proficient in the use of Microsoft Office, including but not limited to Outlook, Word, and Excel. Great attention to detail and follow up, and verbal/written communications skills.
DESIRED:
Advanced degree. Minimum 2 years professional experience with Medicaid Long Term Care and HCBS programs. Minimum 2 years professional experience with Louisiana Medicaid systems and policy. Minimum 2 years professional experience with liability insurance claims processing. Minimum 1 year professional experience with CPT, ICD-9 or ICD-10 coding, and/or HCPCS. Required Attachments
Please upload the following documents in the Resume/Cover Letter section.
Detailed resume listing relevant qualifications and experience; Cover Letter indicating why you are a good fit for the position and University of Louisiana Systems; Names and contact information of three references;
Applications that do not include the required uploaded documents may not be considered.
Posting Close Date This position will remain open until filled.
Note to Applicant:
Applicants should fully describe their qualifications and experience with specific reference to each of the minimum and preferred qualifications in their cover letter. The search committee will use this information during the initial review of application materials.
References will be contacted at the appropriate phase of the recruitment process.
This position may require a criminal background check to be conducted on the candidate(s) selected for hire.
As part of the hiring process, applicants for positions at the University of New Orleans may be required to demonstrate the ability to perform job-related tasks.
The University of New Orleans is an Affirmative Action and Equal Employment Opportunity employer. We do not discriminate on the basis of race, gender, color, religion, national origin, disability, sexual orientation, gender identity, protected Veteran status, age if 40 or older, or any other characteristic protected by federal, state, or local law.