Key Responsibilities:
• Ability to maintain a high-volume caseload and adhere to the timeliness standard of appeals while conducting the due process review.
• Assist in the achievement of a high performing and positive work environment that will promote the TennCare Mission.
• Daily receives and reviews appeals for potential resolution within policy guidelines. If a resolution cannot be found, make outreach.
• Conduct outreach to explain the state's actions related to TennCare Medicaid programs and coordinate with other staff for the prompt resolution of appeals where necessary.
• Demonstrates attention to detail in researching appeal cases and documenting notes for proper case processing. Attends and actively participates in all unit meetings and problem-solving discussions for workflow improvements. Ability to
navigate TEDS.
Minimum Qualifications:
Education and Experience: Graduation from an accredited college or university with a bachelor's degree in a related field (preferred degree in business administration,management, public health, health policy, paralegal, or legal assistant studies) and 2 years of
relevant work experience. OR an equivalent combination of education and work experience may be considered.
• Ability to foster and maintain cohesive working relationships
• Ability to adapt to changing priorities and deadlines
• Ability to exercise sound judgment
• Strong organizational skills necessary, including the ability to prioritize, multi-task and manage workload to meet specific time frames and deadlines
• Advanced writing and communication skills