Legal Assistant - hybrid Nasville, TN

Job Description

Job Description

The Division of TennCare is seeking an Appeals Litigation LEGAL ASSISTANT Representative for the Appeals Operations Group within Member Services. The Appeals Litigation LEGAL ASSISTANT Representative will work to resolve appeals prior to hearing by identifying

appeals that are prime for outreach, conducting outreach to explain the position of the state or obtain further information to assist in the processing of appeals. The Appeals Litigation LEGAL ASSISTANT Representative will document actions in TEDS (& other systems) when necessary. Additionally, the Appeals Litigation LEGAL ASSISTANT Representative will ensure that due process standards are met in Medicaid appeals by the accurate and timely processing of appeals and all appeals related documents. Finally, the Appeals Litigation LEGAL ASSISTANT Representative will also work collaboratively with management to identify workflow issues and accomplishments.

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.

Requirements

Type

Category

Qualification

Description

Competency

Required

Software

Database

Microsoft Access

No

Skills

Others

Administative Assistant

No

Skills

Others

Correspondence - Email

Yes

Skills

Others

Correspondence - General

Yes

Skills

Others

Customer Service

Yes

Skills

Others

Customer Service Skills

No

Skills

Others

Data Entry

Yes

Skills

Others

Filing

Yes

Software

Others

Internet

No

Skills

Others

Legal

Yes

Software

Others

Microsoft Excel

No

Software

Others

Microsoft PowerPoint

No

Software

Others

Microsoft Word

No

Skills

Others

Typing

Yes

Skills

Others

Verbal Communication

Yes