Medical Team Reviewer

Work for Indiana

Grow your career with the State of Indiana! With more than 50 executive branch agencies, the State of Indiana is a diverse workforce offering employees stimulating and challenging projects across a broad scope of career opportunities. As a State of Indiana employee, you impact the well-being of Indiana’s communities every day.

At the State of Indiana, we don’t just talk about diversity and inclusion – Our goal is to create a welcoming, accessible, and equitable workplace, with a workforce that is representative of the State of Indiana population. As a proud equal opportunity employer, reasonable accommodations may be available to enable individuals with disabilities to complete the application and interview process, as well as perform the essential functions of a role.

Next Level benefits at the State of Indiana are here! Be sure to review our expanded benefit package offerings below.

About the Family & Social Services Administration:

The Division of Family Resources (DFR) within the Family and Social Services Administration (FSSA) is responsible for establishing eligibility for Medicaid, Supplemental Nutrition Assistance Program and Temporary Assistance for Needy Families benefits. The division also manages the timely and accurate delivery of SNAP and TANF benefits. DFR also provides employment and training services to some SNAP and TANF recipients. The division’s overarching focus is the support and preservation of families by emphasizing self-sufficiency and personal responsibility.

Salary: This position traditionally starts at an annual salary of $42,900.00. Salary for this position may be commensurate with education and job experience.

Role Overview: This role Medical Team Reviewer conducts a thorough review of Medicaid Medical Review Packets to determine Medicaid Medical Eligibility for the blind or disabled. You will render eligibility decisions in an accurate and timely manner based on state and federal regulations as well as internal policies and procedures. Your role also collaborates and assists with the Burial Program to help process claims.
The ideal candidate will have three or more year’s professional experience in any of the following areas: health care, social services, public administration, business administration. Related accredited college or university training may substitute for the required experience. A thorough working knowledge of medical terminology is preferred.

A Day in the Life:

The essential functions of this role are as follows:

  • Review medical packets and render an eligibility determination in a timely accurate method.
  • Process all incoming Medicaid applications according to their priority, accelerated, expedited/waiver, regular and progress reports.
  • Determine what information is needed to obtain necessary documents to maintain the appropriate processing flow in case decisions.
  • Collaborate with department physicians as necessary during the application review process
  • Exercise judgment concerning the impact case decisions has and the necessity of accuracy and timeliness.
  • Complete special projects as assigned.

The job profile is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Other duties, responsibilities, and activities may change or be assigned at any time with or without notice.

What You’ll Need for Success:
• Three or more year’s professional experience in any of the following areas: health care, social services, public administration, business administration.
• Related accredited college or university training may substitute for the required experience.
• Must possess a thorough working knowledge of medical terminology.
• Must demonstrate the ability to distinguish the levels of severity of various medical conditions as it relates to the impact on an individual’s daily activities.
• Exceptional communication (verbal and written) skills
• Ability to manage time and adapt to changing priorities
• Must be computer literate and demonstrate the acumen to adapt to the usage of multi data systems
• Must possess motivational skills and demonstrate ability to produce in a high volume fast paced production processing environment where accuracy is highly scrutinized.

Supervisory Responsibilities/Direct Reports:

Benefits of Employment with the State of Indiana:

The State of Indiana offers a comprehensive benefit package for full-time employees which includes:

  • Three (3) medical plan options (including RX coverage) as well as vision and dental plans
  • Wellness Rewards Program: Complete wellness activities to earn gift card rewards
  • Health savings account, which includes bi-weekly state contribution
  • Flexible work scheduling options, including the potential for hybrid remote work for employees whose work may be performed outside state facilities
  • Deferred compensation 457B account (similar to 401k plan) with employer match
  • Two (2) fully-funded pension plan options
  • A robust, comprehensive program of leave policies covering a variety of employee needs, including but not limited to:
    • 150 hours of paid new parent leave
    • Up to 15 hours of paid community service leave
  • Combined 180 hours of paid vacation, personal, and sick leave time off
  • 12 paid holidays, 14 on election years
  • Education Reimbursement Program
  • Group life insurance
  • Referral Bonus program
  • Employee assistance program that allows for covered behavioral health visits
  • Qualified employer for the Public Service Loan Forgiveness Program
  • Free Parking for most positions
  • Free LinkedIn Learning access

Equal Employment Opportunity:

The State of Indiana is an Equal Opportunity Employer and is committed to recruit, select, develop, and promote employees based on individual ability and job performance. Our policy is to provide equal employment opportunity to all people in all aspects of employer-employee relations without discrimination because of race, color, creed, religion, sex, national origin, ancestry, age, sexual orientation, gender identity, physical or mental disability, or veteran status. We will comply with the spirit as well as the letter of all applicable state and federal laws.

If you are a qualified individual with a disability and require reasonable accommodation in completing this application, you can request assistance by contacting the Indiana State Personnel Department at [email protected].

The State of Indiana has established a culture that welcomes equity, inclusion, and opportunity for all employees and applicants. We encourage you to apply if you feel you have the transferrable skills to be successful in this position and we look forward to reviewing your application.

Current Employee? Click here to apply.

Job Category
Social Services
Job Type
unspecified
Salary
USD 42,900.00 per year
Country
United States
City
Indianapolis
Career Level
unspecified
Company
State of Indiana
JOB SOURCE
https://workforindiana.in.gov/job/Indianapolis-Medical-Team-Reviewer-IN-46204/1058217600/