Legal Assistant

Appeals Litigation Legal Assistant Representative

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 tohearing 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 (and 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.

Ability to foster and maintain cohesive working relationships

Ability to adapt to changing priorities and deadlines

Ability to exercise sound judgment

Strong organizational skills necessary, including the ability to prioritize, multi-task and manage workload to meet specific time frames and deadlines

Advanced writing and communication skills

Location Requirements

Candidate must be local. - Candidate must be within 30 miles

Additional Location Details (City, State): - Candidates must be able to commute to the office when needed.

Background Verification

Minimum Verification Requirements - Please complete the following verification with Accurate/InfoCubic upon candidate's selection.

• TN Combined Counties & Statewide Search
• Address History Locator
• National Criminal Record Search
• Sex Offender Registry
• Criminal County & Statewide Search - 7 year search, based on residential address history
• Criminal Federal Search - 7 year search, based on residential address history
• Global Watch AKAs - Search current name and all additional names

Please review the comments section of this requisition for any additional background check requirements.