Medicaid/Medicare Services Specialist I

Responsibilities

• Provide specialized assistance to Medicaid providers, staff within the Department for Medicaid Services, and Medicaid Contractors.
• Respond to providers and Credentialing Agents inquiries on Kentucky Department for Medicaid Services Provider Enrollment eligibility, submission documents, and application status, as well as maintenance required on provider file.
• Collecting information about caller and provider, verifies in different information systems, and enters information into database.
• Entering information into the Customer Relationship Management (CRM) system to assist with call-tracking and quality assurance.
• Provides assistance to providers and government agencies through oral and written response to inquiries.
• Requires the ability to work independently and manage time effectively, as well as to work with difficult issues.
• Implements policy changes as appropriate.
• Performs research of state and federal statutes and regulations relative to provider enrollment.
• Remains abreast of all changes to state and federal laws.

Requirements

• Strong ability in working with Medicaid Partner Portal Application, Medicaid Management Information System, and other provider enrollment research tools.
• Excellent verbal and written communication skills.
• Excellent computer skills, especially in Microsoft Office, with experience using Excel.
• Ability to work independently, with attention to detail; thoroughness and accuracy in completing tasks.
• Ability to apply state and federal regulations to work outcomes.

Qualifications

• Graduate of a college or university with a bachelor's degree.
• Experience in Medicaid and/or Medicare program administration, health insurance administration/systems, eligibility systems, health care research, health care planning, health care financial management, health care policy development or human service or health care administration, insurance billing and/or claims will substitute for the required college on a year-for-year basis.
• Current or prior military experience will substitute for the required college on a year-for-year basis.

Skills

• Strong ability in working with Medicaid Partner Portal Application, Medicaid Management Information System, and other provider enrollment research tools.
• Excellent verbal and written communication skills.
• Excellent computer skills, especially in Microsoft Office, with experience using Excel.

Benefits

• The agency may authorize the selected candidate to telecommute.
• The agency may terminate or modify the telecommuting arrangement at any time.

Pay

Salary: $39,284.88 - $58,927.20 Annually

Schedule

Employment Type: EXECUTIVE BRANCH | FULL TIME | ELIGIBLE FOR OVERTIME PAY | 18A | 37.5 HR/WK