Medicaid/Medicare Services Specialist I
The Department for Medicaid Services (DMS) provides health care access for eligible low-income residents of Kentucky including children, families, pregnant women, the aged and the disabled as well as a number of programs and services directed at specific eligibility and medical needsDMS strives each day to meet the mission of the Cabinet for Health and Family Services to be a diverse and inclusive organization providing programs, services and supports that protect and promote the health and well-being of all Kentuckians and their communities.This Medicaid/ Medicare Services Specialist I position reviews and clarifies the policy of select programs in the Division of Health Care Policy in the Department for Medicaid ServicesIn addition, this position researches and analyzes codes, reimbursement, and limitations for select provider typesEmployee also attends Technical Advisory Committee meetings, other program related meeting, and provides needed reports and information for various stakeholders.Learn more about us at:
https:
//chfs.ky.gov/agencies/dms/Pages/default.aspx />Responsibilities and duties included but are not limited to:
Responds to routine inquiries from providers of Medicaid services. Addresses basic questions regarding policy issues from governmental agencies and the general public and provides information. Coordinates special assignments. Creates and coordinates reports and statistics. Coordinates policy and programs that are assigned. Research federal regulations, state statutes, state regulations, policy, other state regulations, and professional organization guidance for improvement of Division policy and regulations. Create and coordinate education and information pertaining to programs. Research grants and funding opportunities for programs. Participate in meetings. Recommend changes in regulations, legislation, and policy based on research. Address provider claims and claims related issues for programs. Identifies program deficiencies through provider and other agency inquiries. Assists in identifying and referring Medicaid or Medicare program potential fraud, abuse incidents, or claims discrepancies to appropriate office for investigation. Learns to analyze trends in program. Perform other duties as assigned.Preferred Knowledge/Skills:
Research and development experience. Policy and regulatory experience. Medical background. Communication skills. Organizational skills.The Cabinet for Health and Family Services (CHFS) participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in U.SCHFS will only use E-Verify once you have accepted a job offer and completed the Form I-9For more information on E-Verify, or if you believe that CHFS has violated its E-Verify responsibilities, please contact Department of Homeland Security (DHS) at 888-897-7781 or https:
//www.e-verify.gov/. />Minimum RequirementsEDUCATION:
Graduate of a college or university with a bachelor's degree.EXPERIENCE, TRAINING, OR SKILLS:
NONESubstitute EDUCATION for
Experience:
NONESubstitute EXPERIENCE for EDUCATION:
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 basisCurrent or prior military experience will substitute for the required college on a year-for-year basis.SPECIAL REQUIREMENTS (AGE, LICENSURE, REGULATION, ETC.):
NONEWorking ConditionsIncumbents working in this job title primarily perform duties in an office setting.Probationary PeriodThis job has an initial and promotional probationary period of 6 months, except as provided in KRS 18A.111.If you have questions about this advertisement, please contact Eddie Newsome at email protected or 502-564-9308. Recommended Skills Administration Billing Claim Processing Communication Coordinating Financial Management Apply to this job. Think you're the perfect candidate? Apply on company site $('.external-apply-email-saved').on('click', function (event) window.ExternalApply = window.open('/interstitial?jobdid=j3p6nm600qxtk4m3rj0', 'ExternalApply-j3p6nm600qxtk4m3rj0'); ); $(document).ready( function() $(#ads-desktop-placeholder).html(
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n Estimated Salary: $20 to $28 per hour based on qualifications.
https:
//chfs.ky.gov/agencies/dms/Pages/default.aspx />Responsibilities and duties included but are not limited to:
Responds to routine inquiries from providers of Medicaid services. Addresses basic questions regarding policy issues from governmental agencies and the general public and provides information. Coordinates special assignments. Creates and coordinates reports and statistics. Coordinates policy and programs that are assigned. Research federal regulations, state statutes, state regulations, policy, other state regulations, and professional organization guidance for improvement of Division policy and regulations. Create and coordinate education and information pertaining to programs. Research grants and funding opportunities for programs. Participate in meetings. Recommend changes in regulations, legislation, and policy based on research. Address provider claims and claims related issues for programs. Identifies program deficiencies through provider and other agency inquiries. Assists in identifying and referring Medicaid or Medicare program potential fraud, abuse incidents, or claims discrepancies to appropriate office for investigation. Learns to analyze trends in program. Perform other duties as assigned.Preferred Knowledge/Skills:
Research and development experience. Policy and regulatory experience. Medical background. Communication skills. Organizational skills.The Cabinet for Health and Family Services (CHFS) participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in U.SCHFS will only use E-Verify once you have accepted a job offer and completed the Form I-9For more information on E-Verify, or if you believe that CHFS has violated its E-Verify responsibilities, please contact Department of Homeland Security (DHS) at 888-897-7781 or https:
//www.e-verify.gov/. />Minimum RequirementsEDUCATION:
Graduate of a college or university with a bachelor's degree.EXPERIENCE, TRAINING, OR SKILLS:
NONESubstitute EDUCATION for
Experience:
NONESubstitute EXPERIENCE for EDUCATION:
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 basisCurrent or prior military experience will substitute for the required college on a year-for-year basis.SPECIAL REQUIREMENTS (AGE, LICENSURE, REGULATION, ETC.):
NONEWorking ConditionsIncumbents working in this job title primarily perform duties in an office setting.Probationary PeriodThis job has an initial and promotional probationary period of 6 months, except as provided in KRS 18A.111.If you have questions about this advertisement, please contact Eddie Newsome at email protected or 502-564-9308. Recommended Skills Administration Billing Claim Processing Communication Coordinating Financial Management Apply to this job. Think you're the perfect candidate? Apply on company site $('.external-apply-email-saved').on('click', function (event) window.ExternalApply = window.open('/interstitial?jobdid=j3p6nm600qxtk4m3rj0', 'ExternalApply-j3p6nm600qxtk4m3rj0'); ); $(document).ready( function() $(#ads-desktop-placeholder).html(
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n Estimated Salary: $20 to $28 per hour based on qualifications.
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