Lead Medicaid Representative

Posted:
10/28/2024, 5:00:00 PM

Location(s):
Little Rock, Arkansas, United States ⋅ Arkansas, United States

Experience Level(s):
Senior

Field(s):
Medical, Clinical & Veterinary

Current University of Arkansas System employees, including student employees and graduate assistants, need to log in to Workday via MyApps.Microsoft.com, then access Find Jobs from the Workday search bar to view and apply for open positions. Students at University of Arkansas System two-year institutions will also view open positions and apply within Workday by searching for “Find Jobs for Students”.

All Job Postings will close at 12:01 a.m. CT on the specified Closing Date (if designated).


If you close the browser or exit your application prior to submitting, the application process will be saved as a draft. You will be able to access and complete the application through “My Draft Applications” located on your Candidate Home page.
 


Closing Date:

11/30/2024


Type of Position:

Clinical Staff - Nursing


Job Type:

Regular


Work Shift:

Sponsorship Available:

No


Institution Name:

University of Arkansas for Medical Sciences


The University of Arkansas for Medical Sciences (UAMS) has a unique combination of education, research, and clinical programs that encourages and supports teamwork and diversity. We champion being a collaborative health care organization, focused on improving patient care and the lives of Arkansans.
 

UAMS offers amazing benefits and perks (available for benefits eligible positions only):

  • Health: Medical, Dental and Vision plans available for qualifying staff and family
  • Holiday, Vacation and Sick Leave
  • Education discount for staff and dependents (undergraduate only)
  • Retirement: Up to 10% matched contribution from UAMS
  • Basic Life Insurance up to $50,000
  • Career Training and Educational Opportunities
  • Merchant Discounts
  • Concierge prescription delivery on the main campus when using UAMS pharmacy

Below you will find the details for the position including any supplementary documentation and questions you should review before applying for the opening.  To apply for the position, please click the Apply link/button.

The University of Arkansas is an equal opportunity, affirmative action institution. The University does not discriminate in its education programs or activities (including in admission and employment) on the basis of age, race, color, national origin, disability, religion, marital or parental status, protected veteran status, military service, genetic information, or sex (including pregnancy, sexual orientation, and gender identity). Federal law prohibits the University from discriminating on these bases. Questions or concerns about the application of Title IX, which prohibits discrimination on the basis of sex, may be sent to the University's Title IX Coordinator and to the U.S. Department of Education Office for Civil Rights.

Persons must have proof of legal authority to work in the United States on the first day of employment.

All application information is subject to public disclosure under the Arkansas Freedom of Information Act.

At UAMS we value Diversity, Equity and Inclusion.
 

For general application assistance or if you have questions about a job posting, please contact Human Resources at [email protected].


Department:

FIN | CORE HIM Medicaid Enrollment


Department's Website:


Summary of Job Duties:

The Medicaid Representative Lead has extensive knowledge of Medicaid including verification, processing cases, and policies. Major responsibility is reviewing and processing Medicaid cases. The Medicaid Rep-Lead works independently and has comprehensive knowledge of Medicaid categories and policies; knowledge to intervene and solve problems on difficult and complex Medicaid cases; learns and determines eligibility for at least twenty Medicaid categories; maintains extensive knowledge of DHS programs and UAMS internal programs; adheres to all requirements associated with Medicaid Representatives’ job summaries. The Lead will complete second party review of Medicaid Representative cases.


Qualifications:

Minimum Qualifications:

  • Associate degree in business, Healthcare, Finance, or related plus 3 years of Medicaid Enrollment experience and processing Medicaid enrollment for recipients OR 3 years of in healthcare billing or registration OR
  • High School diploma plus 5 years Medicaid Enrollment experience and processing Medicaid enrollment for recipients with 2 years of experience in healthcare billing or registration.
  • Medicaid knowledge about categories - Required.
  • Extensive understanding of regulatory and compliance organizations/agencies is – Required.
  • Able to follow oral and written instructions and communicate with others effectively – Required.
  • Strong computer/basic keyboard skills, telephone skills and general knowledge of office machines including printers and Windows operating systems – Required.
  • Excellent customer relations skills – Required.

Preferred Qualifications:

  • Knowledgeable in advanced medical terminology and medical coding.
  • Knowledgeable in Epic system.
  • Three years of Arkansas DHS Medicaid Enrollment Clerical and Case Processing Systems experience.


Additional Information:

Requirements:

  • Reviews all adult and newborn accounts in Epic that have Medicaid Denials
  • Update appropriate billing indicators for Pending Medicaid and Medicaid Denials
  •  Completes accounts for Medicaid Denials to start the Self-Pay process
  •  Update all FPL statuses as needed in Epic
  •  Review and process Spend Down and EMA applications per alpha-split
  •  Reviews Pending Medicaid accounts for accuracy and contacts appropriate Medicaid Representative for any needed updates/corrections
  • Makes clear and precise notations within Epic and the AR DHS database of application actions
  • Appropriate, moves accounts in Epic that will allow review
  • If applicable, reviews AR DHS database for additional or pending applications on patients
  • If applicable, collect AR DHS Medicaid Enrollment verifications and scan and task into AR DHS database
  • Reviews all adult and newborn accounts in Epic that have Pending Medicaid deferred status per alpha-split
  • Reviews all AR DHS verifications needed and those obtained via AR DHS database
  • Contacts patients on verifications needed in order to continue processing applications
  • Scan in any additional verifications sent in by the patient into AR DHS system and OnBase; update Epic account
  • Other duties as assigned.


Salary Information:

Commensurate with education and experience


Required Documents to Apply:

List of three Professional References (name, email, business title), Resume


Optional Documents:


Special Instructions to Applicants:


Recruitment Contact Information:

Please contact [email protected] for any recruiting related questions.


All application materials must be uploaded to the University of Arkansas System Career Site https://uasys.wd5.myworkdayjobs.com/UASYS  

Please do not send to listed recruitment contact.


Pre-employment Screening Requirements:

Criminal Background Check


This position is subject to pre-employment screening (criminal background, drug testing, and/or education verification). A criminal conviction or arrest pending adjudication alone shall not disqualify an applicant except as provided by law. Any criminal history will be evaluated in relationship to job responsibilities and business necessity.  The information obtained in these reports will be used in a confidential, non-discriminatory manner consistent with state and federal law. 


Constant Physical Activity:

Hearing, Manipulate items with fingers, including keyboarding, Repetitive Motion, Sitting, Talking


Frequent Physical Activity:

Grasping, Reaching


Occasional Physical Activity:

Crouching, Lifting, Pulling, Pushing, Walking


Benefits Eligible:

Yes