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Claims Recovery Specialist

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Claims Recovery Specialist

Salary

$47,673.60 - $69,763.20 Annually

Location

State of Iowa - See Job Description, IA

Job Type

Full-time

Job Number

26-00923

Agency

400 Health & Human Services - Community Access Eligibility

Division

Health and Human Services - Community Access Eligibility

Opening Date

10/17/2025

Closing Date

10/27/2025 11:59 PM Central

LinkedIn Tag

#LI-POST

Point of Contact

Melissa Nation - [email protected]

+ Description

+ Benefits

+ Questions

Job Description

Iowa Department of Health and Human Services (HHS, Division of Community Access, Eligibility Determinations, Integrated Claims Recovery Unit, is seeking a Claims Recovery Specialist (Income Maintenance Worker 2) to support program integrity and provide ongoing cost savings and cost avoidance through eliminating duplicate assistance and establishing overpayment claims for Medicaid, Supplemental Nutrition Assistance Program (SNAP) and FIP. This position is part of a small unit and is one of 12 workers reviewing potential benefit overpayments, determining correct benefit eligibility, and establishing claims.

This is a full-time opportunity, Monday – Friday with typical hours being from 8:00 AM - 4:30 PM with overtime as needed. This position currently has the option to work from their home.

Core Essential Functions:

+ Analyze and interpret complex policies and procedures per state and federal regulations.

+ Collect and analyze information from customers and 3rd parties to calculate and determine eligibility.

+ Communicate effectively via phone, email and in person as needed.

+ Meet daily and monthly processing timeframes.

+ Prepare written documents and can clearly present, both in writing and orally.

+ Effectively manage an individual workload while working within a team.

+ Maintain high attendance.

+ Demonstrate excellent organizational and critical thinking skills.

+ Comply with all State of Iowa regulations and DHS Employee Handbook work rules.

Some specific goals of this position include:

+ Determining eligibility and appropriate benefit amounts and stopping incorrect benefit disbursements.

+ Providing consistency and accuracy of claims establishment thus improving Appeals outcomes.

+ Responding to inquiries regarding overpayments.

+ Establishing and working Intentional Program Violations (IPV), including a heavy volume of testifying at: depositions and hearings, both criminal and administrative.

The ideal candidate will have:

+ Excellent case plan development and critical thinking.

+ Strong communication and customer service.

+ Professional presence and strong work ethic.

+ Solid teamwork and consultation.

Appeals experience is required. Preference will be given for experience in Public Assistance programs. I.e.. Food Assistance, Family Investment Program, and Medicaid.

This position requires successful completion of a criminal background check to include FBI fingerprinting prior to beginning employment.

How to Apply:

For help creating a profile or entering your information, please go to the online Employment Application Guide. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Benefits

Working for the State of Iowa comes with its perks. In addition to a competitive salary, you'll enjoy a comprehensive benefits package designed to support your well-being and professional growth:

+ Health, Dental, and Vision Coverage: Health and dental insurance packages to keep you and your family healthy at a low cost with outstanding coverage!

+ Paid Time Off: Take time to recharge with paid time off, including vacation (96 hours/year to begin, increasing with years of service), sick leave (144 hours/year), and paid holidays (9 days/year).

+ Retirement Plans: Participate in retirement plans such as IPERS (employees contribute 6.29% and the State of Iowa contributes 9.44%) as well as our Retirement Investors Club (RIC), Employer Sponsored Retirement Plan (the State of Iowa matches dollar for dollar up to $75/month).

+ Flexible Spending Accounts: Take advantage of flexible spending accounts for medical and dependent care expenses.

+ Insurance Coverage: Benefit from life insurance and free long-term disability insurance for added peace of mind.

+ Employee Assistance Program: Access resources and support through our Employee Assistance Program for personal and professional challenges.

+ Employee Discount Programs: Enjoy discounts on a variety of goods and services through our employee discount programs.

For additional information on benefits click here .

Click here to see how we compare with other employers or offers by using our Total Compensation Calculator.

Background Checks

Applicants will be required to complete a background check to be considered for this position.

The State of Iowa is an EEO/AA Employer

HHS values those with “lived experience” and encourages adults who were fostered as youth, foster parents, and/or parents who were in the DHS system to apply. Minorities, women, persons with disabilities and veterans are encouraged to apply (Hearing and Speech Impaired – Relay Iowa 1-800-735-2942 TDD).

Our agency uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify

Minimum Qualification Requirements

Sixty semester hours (or equivalent academic units) from an accredited college or university;

OR

a combination of education and experience substituting the equivalent of one year of full-time public contact work experience obtaining, analyzing and/or evaluating data for each year of the required college education (on the basis that thirty semester hours is equal to one year of work experience);

OR

employees withcurrentcontinuous experience in the state executive branch that includes experience equal to 18 months of full-time work at a Clerk Advanced level or above involving public contact experience on a regular basis in a service area.

For additional information, please click on thislink to view the job description (https://das.iowa.gov/sites/default/files/hr/documents/class\_and\_pay/JobClassDescriptions/IncomeMaintenanceWorker2-03089.pdf) .

Why Choose the State of Iowa?

At the heart of our commitment to excellence is a dedication to our most valuable asset – our employees. Discover the outstanding benefits that set us apart as an employer of choice.

Our Robust Benefits Package Includes:

Competitive Compensation:

Enjoy a competitive salary that reflects directly on your skills and expertise.

Keep in mind, your wage is just one part of your total compensation. Unlock the complete value of your employment with the State of Iowa by using our user-friendlyTotal Compensation Calculator (https://das.iowa.gov/media/3773/download?inline) .Gain insights into your comprehensive annual compensation, including salary and State-provided benefits.

Health and Wellness:

Prioritize your well-being with our comprehensive health plans, including medical, dental, and vision coverage. Enjoy the peace of mind knowing that the State of Iowa covers 90% of the premiums, providing you and your loved ones with excellent coverage at a remarkably low cost.

Retirement Planning:

We are proud to offer the Iowa Public Employees Retirement System (IPERS). A defined benefit plan, IPERS benefits are guaranteed for life, meaning once you retire, you will receive the same monthly benefit for the remainder of your life (once vested). We invest in your long-term financial well-being, so you can retire with peace of mind.Click here to learn more about IPERS (https://ipers.org/members) .

Paid Time Off:

Life is unpredictable, and at the State of Iowa, we understand the importance of work-life balance. Our leave policies, including paid holidays, vacation, and sick leave with unlimited accrual, ensure you have the flexibility you need for personal and family matters.

Professional Development:

Elevate your career with continuous learning opportunities. We support your growth through training programs, workshops, and tuition reimbursement.

Employee Assistance Program (EAP):

We care about your well-being beyond the workplace. Access confidential counseling, resources, and support through our Employee Assistance Program.

Diversity and Inclusion:

Be part of a diverse and inclusive workplace that embraces all backgrounds and perspectives. We believe diversity is a strength that drives innovation.

Join Us - Elevate Your Career:

Ready to elevate your career with the State of Iowa?Click here (https://iowa.attract.neogov.com/recruitment/p/benefits) to explore more about our unparalleled benefits and discover what makes us unique. Your success is our priority!

01

Do you understand that the answers to all of the following questions must be truthful, honest, and accurate to the best of your ability? Please read all questions and answers thoroughly and make sure you understand them completely.Ensure the answers to your questions match the information filled out on your application and the attachments you have uploaded. If the answers to your questions are inconsistent with your application information or uploaded attachments, you will be given zero points for the question.Knowingly misrepresenting the facts when submitting any information related to an application, examination, certification, appeal, or any other facet of the selection process will result in your disqualification from this application and future employment with the state of Iowa.

+ Yes - I understand and agree.

+ No

02

PLEASE READ CAREFULLY

Have you filed a registration statement pursuant to the federal Foreign Agents Registration Act of 1938, as amended, 22 U.S.C. §611 et seq?

+ No - I have NOT filed a registration statement pursuant to the federal Foreign Agents Registration Act of 1938, as amended, 22 U.S.C. §611 et seq

+ Yes - I HAVE filed a registration statement pursuant to the federal Foreign Agents Registration Act of 1938, as amended, 22 U.S.C. §611 et seq

03

Do you have sixty semester hours (or equivalent academic units) from an accredited college or university?

+ Yes

+ No

04

How many years do you have of a combination of post high school education AND/OR full-time public contact work experience obtaining, analyzing and/or evaluating data for each year of the required college education? Thirty semester hours is equal to one year of work experience.

+ I do not have any of the education or experience

+ Less than two years of the combined education and/or experience

+ Two years or more of the combined education and/or experience

05

Are you a current State of Iowa employee (executive branch)? IF YES - How many months do you have of full-time work at a Clerk Advanced level or above involving public contact experience on a regular basis in a service area for the State of Iowa?

+ I am not a State of Iowa employee

+ Less than 18 months of full-time work at a Clerk Advanced level or above involving public contact experience on a regular basis in a service area for the State of Iowa

+ More than 18 months of full-time work at a Clerk Advanced level or above involving public contact experience on a regular basis in a service area for the State of Iowa

06

Which best describes your education and experience? (if multiple responses apply for you, please choose the one that has the higher points).

+ Bachelor's Degree (or higher) or 4 plus years work experience with a major/emphasis in a Human Services related field (ie: Social Work, Counseling, Public Administration, Human Resources, Communications, Criminal Justice, Paralegal)

+ Associate's Degree or 2 plus years work experience with a major/emphasis in a Human Services related field (ie: Social Work, Counseling, Public Administration, Human Resources, Communications, Criminal Justice, Paralegal)

+ Not Applicable

07

How many years of full-time work experience do you have communicating with internal and external clients and customers in a call center environment to meet their needs?

+ Five or more years

+ Four to less than five years

+ Three to less than four years

+ Two to less than three years

+ One to less than two years

+ Less than one year

08

How many years of full-time work experience do you have in determining eligibility, need and benefits (or similar experience) for a client?

+ Five or more years

+ Four to less than five years

+ Three to less than four years

+ Two to less than three years

+ One to less than two years

+ Less than one year

09

How many years of full-time work experience do you have utilizing independent judgement to make correct decisions based on information received?

+ Five or more years

+ Four to less than five years

+ Three to less than four years

+ Two to less than three years

+ One to less than two years

+ Less than one year

10

How many years of full-time work experience do you have interpreting information received and determining whether it meets criteria found in various policies or regulations?

+ Five or more years

+ Four to less than five years

+ Three to less than four years

+ Two to less than three years

+ One to less than two years

+ Less than one year

11

How many years of full-time work experience do you have utilizing computer systems to document information while simultaneously obtaining it from the caller?

+ Five or more years

+ Four to less than five years

+ Three to less than four years

+ Two to less than three years

+ One to less than two years

+ Less than one year

Required Question

Employer

State of Iowa

Website

hhs.iowa.gov

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