Claims Research - Coordinator


Medicaid Technical Services Contract


One position located in Baton Rouge.


  • Work within the managed care section to ensure issues related to medical claims are addressed in a timely manner to ensure contract compliance by each managed care organization (MCO), as well as timely and responsive MCO and provider support.
  • Communicate with providers and other external stakeholders to improve care delivered and to address Medicaid programmatic issues.
  • Serve as liaison with the MCOs and LDH MMIS, Eligibility and Systems staff to address questions and complaints related to claims issues.
  • Review monthly denied claims reports and provide analysis to provider relations program manager.
  • Complete special research projects.
  • Analyze regular reporting by the MCOs.
  • Perform other tasks as directed.


  • Bachelor Degree, or 6 years of professional experience in lieu of degree.
  • Experience working in a medical provider’s office or hospital setting for at least 5 years in the billing or coding department.
  • Extensive knowledge of provider claims submittal requirements, posting payments, recoupments and denials.
  • Extensive background working insurance company denials to investigate edits, database, coding and other errors.
  • Experience working directly with patients to resolve patient billing complaints, and knowledge of HIPAA guidelines and regulations.
  • Excellent analytical skills, effective organizational and time management skills.
  • Comfortable working in fast paced environment. Works well both independently and as part of a team.
  • Highly self-motivated.
  • Able to independently initiate communication with stakeholders.


  • Bachelor Degree in Public Health, Community Health or Healthcare Management.
  • Certified medical coder through AHIMA or AAPC.
  • 10 years of healthcare related experience.
  • Professional experience in Medicaid program support.
  • Professional experience working with insurance or Medicare.
  • Experience in writing policy.
  • Experience in reporting and statistical analysis.
  • Proficient in MS Office.


Commensurate with qualifications and experience.







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The University of New Orleans is an Affirmative Action / Equal Employment Opportunity employer. We do not discriminate on the basis of race, gender, color, religion, national origin, disability, protected Veteran status, age if 40 or older, or any other characteristic protected by federal, state, or local law.