Medicaid Appeals & Disability Representative
Job ID:
R242602
Shift:
1st
Full/Part Time:
Full_time
Pay Range:
$25.30 – $37.95
Location:
Milwaukee, WI – 7800 N 113th St
Milwaukee, WI 53224
Benefits Eligible:
Yes
Hours Per Week:
40
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
Compensation
- Base compensation within the position’s pay range based on factors such as qualifications, skills, relevant experience, and/or training
- Premium pay such as shift, on call, and more based on a teammate’s job
- Incentive pay for select positions
- Opportunity for annual increases based on performance
Benefits and more
- 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
Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc); please ask a Recruiter for more information during an interview.
Schedule Details/Additional Information:
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.
Essential Functions
- Requests medical records for review. Analyze the medical condition of the patient to determine if they meet a disability listing.
- Analyzes and make 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 to include preparation of witnesses for hearing.
- Analyzes legal issues applicable to the specific denial situation. Actively participates in hearing proceeding to include presentation of oral and written arguments. Reviews and responds to written summary prepared by county officers.
Physical 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.
Education, Experience and Certifications
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.
Aurora Health Care is the largest health system in Wisconsin and a national leader in clinical innovation, health outcomes, consumer experience and value-based care. The state’s largest private employer, the system serves patients across 17 hospitals, more than 70 pharmacies and more than 150 sites of care. Aurora Health Care, in addition to Advocate Health Care in Illinois and Atrium Health in the Carolinas, Georgia and Alabama, is now part of Advocate Health, the third-largest nonprofit, integrated health system in the United States. Committed to providing equitable care for all, Advocate Health provides nearly $5 billion in annual community benefits.