Job Description
Job Description
Shift time : 8 : 00 AM - 4 : 30 PM CST
Description :
- APPLICANTS / RESOURCES may also be expected to help with workload in either Litigation or Legal Review (whichever area they are not currently in) based on volume and work demands
- To support an influx of eligibility appeals, the (Legal Review Attorney) unit is requesting additional support in the attorney capacity to ensure federal timeline requirements can continue to be met with high quality.
- The selected attorney contractors may be prohibited from the practice of law outside of their TennCare assignment.
- This is due to potential conflicts of interest, etc. Please inform all candidates submitted.
Description of Duties :
Research and review appeal in Tennessee Eligibility Determination System (TEDS) database and make a valid factual dispute determination. 25% of total work effortAcquire and maintain a thorough understanding of Medicaid statutes, regulations, and policies. 25% of total work effortReview and monitor cases and appeals to ensure they are processed in compliance with Medicaid statutes, regulations, and policies. 25% of total work effortIdentify issues affecting eligibility determinations and appeals and propose remedial measures. 25% of total work effortMinimum Qualifications :
Bachelor’s Degree from an accredited college or universityJuris Doctor from an accredited college or universityActive License to practice law in TennesseeAbility to foster and maintain cohesive working relationshipsAbility to adapt to changing priorities and deadlinesAbility to exercise sound judgmentExcellent organizational skills necessary, including the ability to prioritize, multi-task and manage workload to meet specific timeframes and deadlinesExcellent writing and communication skills requiredAbility to interpret and execute public policyAbility to interface with multiple computer systems and applicationsDesirable Qualifications :
Knowledge of and experience with eligibility appeals procedures a plusPrevious legal review experience a plusCompany Description
We believe in service that helps you solve a problem, move forward with a project, manage a difficult situation, or simply check something off your list.
Company Description
We believe in service that helps you solve a problem, move forward with a project, manage a difficult situation, or simply check something off your list.