Claims Research - Coordinator

(1 Position located in Baton Rouge)

POSITION #: 9380

DEPARTMENT: Medicaid Services Contract – Claims Research

• 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.
• 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.
• Basic medical coding (CPT and ICD10) knowledge and a complete understanding of provider claims, such as claims submittal requirements, posting payments, recoupments and working 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 fastpaced environment.
• Works well both independently and as part of a team.
• Highly selfmotivated.
• Able to independently initiate communication with stakeholders.

• Bachelor Degree in Public Health, Community Health or Healthcare Management.
• 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.

SALARY: Commensurate with qualifications and experience.

APPLICATION PROCEDURE: Applicants should submit a cover letter and resume (including salary requirement) to Dara Horcasitas at with the job title in the email subject line.

CLOSING DATE: Position will remain open until filled. To assure full consideration, applications should be received by May 23, 2017.

All applicants will be considered for employment without regard to retirement status and without regard to an applicant's having previously accused the UL System Board or any of its universities of unlawful discrimination. Retirement status shall not be considered in the hiring process by any University in the UL System.
The University of New Orleans is an Affirmative Action/Equal Employment Opportunity employer. Women, ethnic minorities, veterans and persons with disabilities are encouraged to apply.