State of Louisiana · 2 months ago
Recovery - Coordinator 2
Houma-Thibodaux Area
Full-time
Onsite
Entry, Mid Level
1+ years expState of Louisiana is seeking a Recovery Coordinator 2 who will serve as the subject matter expert in Third-Party Liability Recovery issues. The role involves maintaining knowledge of Medicaid policies, conducting advanced research of claims, and pursuing the recovery of funds from third parties.
Government Administration
Responsibilities
Serves as the subject matter expert in Third-Party Liability (TPL) Recovery issues related to Estate, Trauma, Special Needs Trusts, and/or restitution recoveries. Provides support for and may send responses to escalated matters
Maintains an advanced working knowledge of Medicaid and Eligibility policy to interpret Medicaid claims
Participates in the development and implementation of TPL policies and procedural changes related to Estate, Trauma, Special Needs Trusts, and/or restitution recoveries
Performs advanced research of claims to identify claims associated with accident-related diagnoses and treatments and/or applicable to various recovery types
Performs advanced calculations to determine appropriate claims recovery amounts and processes incoming payments
Provides support to the Medicaid Fraud and Recovery Investigative Unit’s ongoing, statewide operational activities relative to restitution and fraud recoveries
Pursues the recovery of funds from third parties (including the estates and Trusts of deceased recipients), as appropriate and according to established policies and procedures; includes issuance of recovery notices and assistance to LDH’s Bureau of Legal Service when defending LDH’s interest in legal proceedings
May conduct extensive asset, estate, succession, claim, and other necessary case research, potentially involving escalated matters. Requires regular coordination with LDH’s Bureau of Legal Service, families of deceased Medicaid recipients, attorneys, insurance companies, and other third parties, in the regular management of assigned Recovery caseload and general recovery matters, potentially including escalations
Serves as the LDH representative for recovery matters under appeal, including preparation of Summaries of Evidence and other documentation and processes required of the LDH’s and Department of Administrative Law’s fair hearing processes. Makes recommendations for system changes required due to changing federal and/or state regulations, Medicaid policies, and other factors including system modernization efforts
May lead the planning, development, design, testing, and implementation of changes and/or new specifications to the recovery system
May serve as backup to management (i.e. Medicaid Program Supervisor, Medicaid Program Manager 1B)
Other tasks as assigned
Qualification
Required
Bachelor's degree, or Associate's degree plus 3 years of professional experience, or 6 years of professional work experience
Minimum 1 year professional experience with Medicaid Long Term Care and Home and Community Based Service (HCBS) programs
Excellent analytical skills, effective organizational and time management skills
Ability to manage projects, assignments, and competing priorities
Proficient in the use of Microsoft Office, including but not limited to Outlook, Word, and Excel
Great attention to detail and follow up, and verbal/written communications skills
Preferred
Advanced degree
Minimum 2 years professional experience with Medicaid Long Term Care and HCBS programs
Minimum 2 years professional experience with Louisiana Medicaid systems and policy
Minimum 2 years professional experience with liability insurance claims processing
Minimum 1 year professional experience with CPT, ICD-9 or ICD-10 coding, and/or HCPCS
Company
State of Louisiana
Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity to make a difference through public service.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Chancellor Donald, M.D.
Chief Medical Officer
Chase Hymel
Chief Information Security Officer (CISO)
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