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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).
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
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.
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