Quality Control - Coordinator 1

uno.edu

Medicaid eligibility case review
Policy and procedure compliance
Audit documentation and exhibits
The position involves reviewing 20 to 40 assigned eligibility cases monthly for compliance with Medicaid and CHIP policies using various data sources

Job Summary

  • The position involves reviewing 20 to 40 assigned eligibility cases monthly for compliance with Medicaid and CHIP policies using various data sources.
  • The coordinator maintains a high degree of knowledge of Medicaid policy changes and proficiency in navigating Louisiana’s Medicaid eligibility system.
  • Applicants must submit a detailed resume, cover letter, and references, and the position may require a criminal background check.

Matching Summary

The position involves reviewing 20 to 40 assigned eligibility cases monthly for compliance with Medicaid and CHIP policies using various data sources.

Skills & Requirements

Must-have

  • Medicaid eligibility case review
  • Policy and procedure compliance
  • Audit documentation and exhibits
  • Medicaid and CHIP policy interpretation
  • Microsoft Office proficiency
  • Project and time management

Nice-to-have

  • Analytical and organizational skills
  • Attention to detail and follow up
  • Experience with eligibility systems
  • Meeting collaboration with Medicaid staff
  • Special projects for health department

Key Requirements

  • Bachelor’s Degree or equivalent experience
  • Minimum 1 year Medicaid/CHIP program experience
  • Knowledge of state medical coverage eligibility
  • Proficient in Microsoft Office
  • Preferred 2 years Medicaid/CHIP experience
  • Preferred 1 year auditing experience
  • Relevant industry certifications

Work Rights

Not specified

Tailored Resume

Cover Letter