Eligibility Hearings Specialist

Conduent Incorporated Topeka , KS 66604

Posted 3 weeks ago

About Conduent

Conduent delivers mission-critical services and solutions on behalf of businesses and governments - creating exceptional outcomes for its clients and the millions of people who count on them. Through people, process and technology, Conduent solutions and services automate workflows, improve efficiencies, reduce costs and enable revenue growth. It's why most Fortune 100 companies and over 500 government entities depend on Conduent every day to manage their essential interactions and move their operations forward.

Conduent's differentiated services and solutions improve experiences for millions of people every day, including two-thirds of all insured patients in the U.S., 11 million employees who use its HR Services, and nearly nine million people who travel through toll systems daily. Conduent's solutions deliver exceptional outcomes for its clients including $17 billion in savings from medical bill review for workers compensation claims, up to 40% efficiency increase in HR operations, and up to 40% improvement in processing costs, while driving higher end-user satisfaction. Learn more at www.conduent.com.

Job Description

  • The position is in Topeka, KS, however, the work may be performed from home at times considering the economic and office impact of Covid-19

Job Description:

As part of the KanCare Clearinghouse Program, the Hearings Eligibility Specialist is specially trained and dedicated to the Hearings unit. The Hearings Eligibility Specialist will have an added level of knowledge of Medicaid programs, policy, and procedures.

Essential duties may include, but are not limited to:

  • Participates in a pre-hearing conferences with appellant and in conjunction with KDHE on-site staff, who are appealing the eligibility decision for Medicaid programs, as needed

  • Review the case file to determine the appropriate documents needed to process the hearing request. Determine whether an agency summary is needed, if additional time is needed to complete an agency summary, or if a dismissal of the fair hearing request should be requested

  • Re-evaluate the eligibility decision or issue identified in the hearing request when appropriate

  • Complete all necessary follow up with appellant and OAH resulting from the pre-hearing conference

  • Prepare and distribute agency summary packets, dismissal requests, and other hearing documents as required to complete the processing of a fair hearing request within required time frames as directed by on-site KDHE staff and KDHE Legal

  • Complete, or coordinate completion, of any subsequent case action resulting from the hearing decision as directed by the KDHE contact or KDHE Legal

  • The ability to provide an enhanced level of customer service and assists consumers with understanding their rights and responsibilities under the appeal process

  • Maintain with up-to-date knowledge of regulations, policies, and guidelines

  • Attend training as assigned to develop and enhance current understanding of Kansas Medicaid eligibility programs

  • Maintains relationships with all KDHE on-site fair hearing contact(s).

Minimum Qualifications/Experience

  • High School diploma or GED equivalent; some college preferred

  • Minimum of two (2) years' experience in determining Long-Term Care, Elderly and Disabled, or Family Medical eligibility

  • Minimum of (6) months' experience in an Eligibility Professional role

  • Successfully complete KDHE Eligibility Training

Preferred Skills or Knowledge:

  • Knowledge of Medicaid and managed care programs

  • Strong computer skills with the ability to maneuver in complex software systems

  • Intermediate level of skill with MS Office, Outlook, and Internet usage

  • Ability to manage competing priorities

  • Demonstrated critical thinking skills

  • Requires excellent data entry skills

  • Willingness to work as part of a team

  • Independently perform specialized and/or complex work assignments

  • Must possess good interpersonal and communication skills both verbally and in writing including knowledge of basic grammar, spelling & punctuation

  • Maintain the integrity and confidentiality of all records and communications

  • All other duties as assigned

Closing

Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the "Submit" button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form. You may also click here to access Conduent's ADAAA Accommodation Policy.

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Eligibility Hearings Specialist

Conduent Incorporated