Medical Assistance Program Technician

Commonwealth-of-Pennsylvania; Harrisburg (Dauphin County); Hybrid; USD 40,000 - 52,000; Full time

Job summary

The Commonwealth of Pennsylvania Department of Health is seeking a Medical Assistance Program Technician to support the Chronic Renal Disease Program by reviewing, processing, and approving health care claims. The role emphasizes accuracy, service, and public health while providing guidance to staff, providers, and claimants.

The position requires careful evaluation, clear communication, and attention to detail, with duties spanning invoice review, payment calculations, adjudication, and

Qualifications

• Three years of para-technical experience which involved reviewing and responding to inquiries relating to applicable services or benefits in health care insurance programs, health care services, or medical assistance program services; or
• Any equivalent combination of experience and training.

Responsibilities

• Invoice Review: Review provider invoices and verify eligibility, service details, and supporting information
• Payment Calculation: Calculate claim payments by checking fee schedules, third-party payments, and diagnostic data
• Claim Adjudication: Approve accurate claims, deny incorrect submissions, and return items needing correction
• Technical Support: Provide guidance to staff, providers, and cardholders regarding billing issues and claim status
• Record Maintenance: Update system information, track discrepancies, and document processing actions
• Customer Assistance: Respond to inquiries by using multiple systems to find eligibility information and payment status

Job description

Are you eager to support a program that helps individuals manage vital medical needs? As a Medical Assistance Program Technician with the Department of Health, you will join a team that keeps important services moving smoothly. This role offers the chance to help people understand billing requirements and ensure claims are handled correctly. Your work will support a mission focused on accuracy, service, and public health.

This position focuses on reviewing, processing, and approving claims in support of the Chronic Renal Disease Program. The work requires careful evaluation, clear communication, and steady attention to detail. As a Medical Assistance Program Technician, you will perform the following duties:

• Invoice Review: Review provider invoices and verify eligibility, service details, and supporting information
• Payment Calculation: Calculate claim payments by checking fee schedules, third-party payments, and diagnostic data
• Claim Adjudication: Approve accurate claims, deny incorrect submissions, and return items needing correction
• Technical Support: Provide guidance to staff, providers, and cardholders regarding billing issues and claim status
• Record Maintenance: Update system information, track discrepancies, and document processing actions
• Customer Assistance: Respond to inquiries by using multiple systems to find eligibility information and payment status

Interested in learning more? Additional details regarding this position can be found in the position description.

Work Schedule and Additional Information:

• Full-time employment, 37.5 hours per week
• Work hours are 8:00 AM to 4:30 PM, Monday - Friday, with a 60-minute lunch.
• Telework: You may have the opportunity to work from home (telework) part-time. In order to telework, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. If you are unable to telework, you will have the option to report to the headquarters office in Harrisburg. The ability to telework is subject to change at any time. Additional details may be provided during the interview.
• Salary: In some cases, the starting salary may be non-negotiable.
• You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.

QUALIFICATIONS

Minimum Experience and Training Requirements:

• Three years of para-technical experience which involved reviewing and responding to inquiries relating to applicable services or benefits in health care insurance programs, health care services, or medical assistance program services; or
• Any equivalent combination of experience and training.

Other Requirements:

• You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency Guidelines.
• You must be able to perform essential job functions.

Veterans

• Pennsylvania law (51 Pa. C.S. §7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to www.pa.gov/agencies/employment/how-to-apply.html and click on Veterans.

Telecommunications Relay Service (TRS)

• 711 (hearing and speech disabilities or other individuals).

If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.

The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.

• Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam).
• Your score is based on the detailed information you provide on your application and in response to the supplemental questions.
• Your score is valid for this specific posting only.
• You must provide complete and accurate information or:
  • your score may be lower than deserved.
  • you may be disqualified.
• You may only apply/test once for this posting.
• Your results will be provided via email.