Job Description

Job 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 unit is requesting additional support in the attorney capacity to ensure federal timeline requirements can continue to be met with high quality.

This position is Hybrid - the number of office days/remote days will be determined by the client unit.

Description of Duties

• Research and review appeals in Tennessee Eligibility Determination System (TEDS) database and make a valid factual dispute determination. 25% of total work effort.
• Acquire and maintain a thorough understanding of Medicaid statutes, regulations, and policies. 25% of total work effort.
• Review and monitor cases and appeals to ensure they are processed in compliance with Medicaid statutes, regulations, and policies. 25% of total work effort.
• Identify issues affecting eligibility determinations and appeals and propose remedial measures. 25% of total work effort.

Minimum Qualifications

• Bachelor's Degree from an accredited college or university.
• Juris Doctor from an accredited college or university.
• Active License to practice law in Tennessee.
• Ability to foster and maintain cohesive working relationships.
• Ability to adapt to changing priorities and deadlines.
• Ability to exercise sound judgment.
• Excellent organizational skills necessary, including the ability to prioritize, multi-task and manage workload to meet specific timeframes and deadlines.
• Excellent writing and communication skills required.
• Ability to interpret and execute public policy.
• Ability to interface with multiple computer systems and applications.

Desirable Qualifications

• Knowledge of and experience with eligibility appeals procedures a plus.
• Previous legal review experience a plus.

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