Specialist II Estate Recovery

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Specialist II, Estate Recovery
RESPONSIBILITIES: Continue to refine and enhance current operations, implementing innovative methods to identify new cases, verify claims and recover payments originally paid by Medicaid and/or other state funded programs based on federal and state statutes and regulations. Research, maintain and understand compilation of all Federal and State statutes and regulations pertaining to Third Party and Estate Recovery to ensure Medicaid is the payer of last resort. Maintain a caseload as assigned, following established protocols Identify benefits paid by Medicaid and calculate the total value to be recovered in each case. Represent the best interest of the Medicaid program consistent with the goals and objectives of CHCF Request and produce claims history printouts including all service reports from Medicaid history databases for recipient payment history. Investigate and document all case related matters and relevant financial and medical history in order to support a claim against the probate estate or third party settlements of a Medicaid member.. Provide training of support staff. Maintain and update Recovery training manual. Maintain all case records as required for an established time period. Communicate and collaborate with probate courts, attorneys, hospitals, insurance companies and other relevant entities to insure all Medicaid related Estate Recovery cases are referred to the unit and processed accordingly. Conduct legal research through the use of public databases and web based applications and prepare legal memoranda and other case related documents for referral to Medicaid EHS legal department.. Research record of ownership and title of real estate at the Registry of Deeds.

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