[Hiring] Medicaid Appeals & Disability Representative @American Addiction Centers

Role Description

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.

• Requests medical records for review.
• Analyze the medical condition of the patient to determine if they meet a disability listing.
• Analyzes and makes 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, including preparation of witnesses for hearing.
• Analyzes legal issues applicable to the specific denial situation.
• Actively participates in hearing proceedings, including presentation of oral and written arguments.
• Reviews and responds to written summary prepared by county officers.

Qualifications

• 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.

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.

Benefits

• 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.