Medical Claims & Recovery Technician — Telework Eligible

Commonwealth of Pennsylvania; Pennsylvania; Hybrid; USD 42,000 - 64,000; Full time

Benefits offered by this job

Telework option

Free parking

Job summary

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.

Responsibilities

• 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.

Skills

Para-technical exp

Health care benefits

Job description

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