Medicaid Appeals & Disability Representative
Department: 10339 Enterprise Revenue Cycle - Enrollment: Midwest Status: Full time
Benefits
Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: Remote position covering Wisconsin and Illinois Disability Medicaid Applications and Medicaid appeals. May require some travel to agency site locations for hearings. Monday through Friday 8:00-4:30 pm. Pay Range $25.30 - $37.95 Essential Functions Requests medical records for review. Analyze the medical condition of the patient to determine if they meet a disability listing. Analyzes and make decisions regarding performing appeal or accepting denial. Provides Financial Counselors with input on cases requiring further medical review. Prepares written arguments to present to the Income Maintenance Casework, local, and state hearing officers to include preparation of witnesses for hearing. Analyzes legal issues applicable to the specific denial situation. Actively participates in hearing proceeding to include presentation of oral and written arguments. Reviews and responds to written summary prepared by county officers. Physical Requirements Works in patient's room or a fast-paced office environment with numerous interruptions. Must be able to travel to represent patient at appeals. Work closely with attorney/paralegal for guidance on difficult eligibility issues. Education, Experience and Certifications High School Diploma or GED required; Bachelor's Degree preferred. 5 years experience in financial counseling, DSS or Medical appeals required. Previous experience with appeals and state hearings preferred. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
Compensation
Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview. About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits. Apply To This Job