Medical Malpractice Coverage Specialist

Commonwealth of Pennsylvania; Harrisburg (Dauphin County); Hybrid; USD 48,000 - 58,000; Full time

Benefits offered by this job

Telework options

Job summary

Commonwealth of Pennsylvania in Harrisburg seeks a Medical Malpractice Coverage Specialist who analyzes coverage information, ensures submissions meet program requirements, and provides guidance to insurance professionals. The role includes reviewing payments, maintaining records, and supporting process improvements within the Insurance, Administration, and Coverage Compliance Division.

The position emphasizes strong analytical skills, attention to detail, and the ability to work collaboratively

Qualifications

• Three years of experience in reviewing and examining medical malpractice insurance filings, forms, or policies.
• Two years of college or business school or equivalent training.

Responsibilities

• Coverage Review: Analyze insurance coverage information and determine whether submissions meet program requirements
• Payment Evaluation: Review funds received on behalf of health care providers as well as track credits and debits for accuracy
• Compliance Support: Identify potential compliance concerns and report findings to appropriate program staff
• Technical Guidance: Assist insurance professionals with reporting requirements, coverage transactions, and system processes
• Records Management: Maintain coverage and compliance records using agency systems and document management tools
• Process Improvement: Support procedure reviews, prepare reports, and contribute to special projects and presentations

Education

Three years of experience in reviewing and examining medical malpractice insurance filings, forms, or policies

Two years of college or business school

Job description

The Insurance, Administration, and Coverage Compliance Division is seeking a Medical Malpractice Coverage Specialist who enjoys analytical work and helping others navigate complex requirements. This position gives you the opportunity to review important records, resolve discrepancies, and provide guidance to industry professionals. Your work will contribute to effective program administration and compliance efforts. Take the next step in a career that combines technical knowledge with meaningful service.

This position reviews medical malpractice insurance coverage information and related payments to ensure compliance with Pennsylvania requirements. Work involves providing guidance, resolving coverage issues, maintaining records, and supporting process improvements. As a Medical Malpractice Coverage Specialist, you will perform the following duties:

• Coverage Review: Analyze insurance coverage information and determine whether submissions meet program requirements
• Payment Evaluation: Review funds received on behalf of health care providers as well as track credits and debits for accuracy
• Compliance Support: Identify potential compliance concerns and report findings to appropriate program staff
• Technical Guidance: Assist insurance professionals with reporting requirements, coverage transactions, and system processes
• Records Management: Maintain coverage and compliance records using agency systems and document management tools
• Process Improvement: Support procedure reviews, prepare reports, and contribute to special projects and presentations

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 4:30 PM, Monday - Friday, with a 60-minute lunch.
• Telework: You may have the opportunity to work from home (telework) part-time, up to 3 days per week. Additional in-person reporting may be required for training, on-site events, equipment issues, etc. 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: Selected candidates who are new to employment with the Commonwealth of Pennsylvania will begin employment at the starting annual salary of $53,008.00 (before taxes).
• 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 experience in reviewing and examining medical malpractice insurance filings, forms, or policies, and two years of college or business school;
• An equivalent combination of experience and training, which included at least one year of experience in reviewing and examining medical malpractice insurance filings, forms or policies.

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.