Medical Assistance Program Technician

Commonwealth of Pennsylvania; Pennsylvania; Hybride; USD 42 000 - 64 000; Plein temps

Avantages offerts par ce poste

Telework option

Free parking

Résumé du poste

Commonwealth of Pennsylvania seeks a Medical Assistance Program Technician to support the Bureau of Program Integrity, Division of Third Party Liability, Recovery Section. You will review, analyze, and compute medical, cash, personal injury, and estate claims to ensure accurate, standards-based recovery efforts.

The role emphasizes decoding and summarizing information, gathering details from facilities and agencies, and applying federal/state regulations to ensure timely and correct claim

Qualifications

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

Responsabilités

• Decode, analyze, calculate, and summarize information in medical claims.
• Review complex medical claims to determine relation to personal injury or decedent estate cases.
• Contact facilities and agencies to obtain required details.
• Update medical and cash payment amounts using correct federal standards.
• Identify adjustments to claims to create/update statements of claim.
• Apply federal and state regulations to follow proper procedures.

Connaissances

Para-technical exp

Health care benefits

Description du poste

THE POSITION

Are you interested in technical and administrative work that helps state medical assistance program services run fairly and effectively? Apply for this Medical Assistance Program Technician role with the Bureau of Program Integrity, Division of Third Party Liability, Recovery Section, Statement of Claim Creation Unit. With us, you will review, analyze, and compute medical, cash, personal injury, and estate claims in which the Commonwealth seeks recovery, ensuring work is accurate, consistent, and uses the correct standards. Take the next step in your career as part of a team that works to protect public resources, strengthen financial accountability, and support community wellbeing!

THE POSITION

Are you interested in technical and administrative work that helps state medical assistance program services run fairly and effectively? Apply for this Medical Assistance Program Technician role with the Bureau of Program Integrity, Division of Third Party Liability, Recovery Section, Statement of Claim Creation Unit. With us, you will review, analyze, and compute medical, cash, personal injury, and estate claims in which the Commonwealth seeks recovery, ensuring work is accurate, consistent, and uses the correct standards. Take the next step in your career as part of a team that works to protect public resources, strengthen financial accountability, and support community wellbeing!

DESCRIPTION OF WORK

This position focuses on decoding, analyzing, calculating, and summarizing information in medical claims. Work supports accurate and timely creation and processing for statement of claims across various medical and financial situations. As a Medical Assistance Program Technician, you will perform the following duties:

• Claim Analysis: Independently review complex medical claims to determine which relate to specific personal injury or decedent estate cases
• Information Gathering: Contact facilities and agencies as well as analyze correspondence and forms to obtain required details
• Computations: Calculate and update medical and cash payment amounts by determining the amount of cash received using the correct standards permitted by federal law
• Data Explanations: Review and interpret complex client encounter data from managed care organizations to explain the fiscal processes determining the amount due and owed
• Adjustment Updates: Identify adjustments made to claims to create and update statement of claims
• Regulation Knowledge: Apply federal and state regulations and policies to independently identify and follow proper procedures.

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

Work Schedule and Additional Information

• Full-time employment
• Work hours are 8:00 AM to 4:00 PM, Monday - Friday, with a 30-minute lunch.
• Free parking.
• Telework: You may have the opportunity to work from home (telework) part-time, up to three days per week. 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.

Required Experience, Training & Eligibility

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.

EXAMINATION INFORMATION

• 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.