Medical Assistance Program Technician

2 weeks ago

Harrisburg, Pennsylvania, United States Commonwealth of Pennsylvania Full time
THE POSITION

Are you looking for fulfilling work supporting programs with a positive impact on the lives of others? The Bureau of Data and Claims Management, Division of Managed Care Systems Support is in search of a Medical Assistance Program Technician to oversee programs administered by the Office of Medical Assistance. Responsibilities include compiling, distributing, and tracking data or requests needed for rate development and monitoring reimbursement methods for capitation, maternity care, and special incentive payments. You will also manage membership in Managed Care Plans (MCOs). If you thrive in a collaborative team environment to achieve goals and tasks, this might be the ideal job for you.

DESCRIPTION OF WORK

In this role, you will handle electronic requests from Managed Care Organizations (MCOs); County Assistance Offices (CAOs); Enrollment Assistance Contractor (EAC); Health Insurance Premium Payment (HIPP); Living Independence for the Elderly (LIFE); Children, Youth and Families (CYF); and the Bureau of Managed Care Operations (BMCO) to enroll or disenroll recipients from managed care or to correct coverage as per the plan agreements for HealthChoices state-wide managed care programs. You will update the Client Information System (CIS) regarding managed care coverage and communicate changes to CAO to correct Medical Assistance (MA) eligibility or add facility or waiver code details. Processing claim adjustments, initiating capitation payments to PROMISe, and possessing knowledge of the HealthChoices contract and CIS are crucial for this role.

In addition, you will offer technical support for maternity care payment processes, handle requests to enroll newborns, conduct thorough research to complete necessary actions in various programs, review incoming information to process claims, and assess recipient eligibility for enrollment or disenrollment.

Interested in discovering more? Additional information on this position can be found in the detailed position description.

Work Schedule and Additional Information:

  • Full-time position
  • Work hours from 8:00 AM to 4:30 PM, Monday to Friday, with a 60-minute lunch break
  • Telework: Option to work part-time from home, requiring a secure high-speed internet connection from an approved location within Pennsylvania. Office presence required at least one day per month. If unable to telework, reporting to headquarters office in Harrisburg is necessary.
  • Salary: Starting salary may be non-negotiable in specific cases
  • Further communication regarding this position will be via email. Check all email folders for notifications.

REQUIRED EXPERIENCE, TRAINING & ELIGIBILITY

QUALIFICATIONS

Minimum Experience and Training Requirements:

  • Three years of para-technical experience involving responding to inquiries in health care insurance programs, healthcare services, or medical assistance services; or
  • Equivalent combination of experience and training

Other Requirements:

  • Must meet PA residency requirement. Refer to Residency for details.
  • Capable of performing essential job functions

How to Apply:

  • Application review excludes resumes, cover letters, or similar documents. Position eligibility is solely based on information provided in the application.
  • If claiming education in responses, attach college transcripts for consideration.
  • Application deadline must be met. Late submissions not accepted.
  • Non-compliance with application requirements may result in disqualification.

Veterans:

  • Employment preference for qualified veterans in accordance with Pennsylvania law (51 Pa. C.S. *7103). For veteran employment preferences, refer to the Veterans' Preference tab.

Telecommunications Relay Service (TRS):

  • 711 for individuals with hearing and speech disabilities

Interview accommodations for disabilities are available upon request. The Commonwealth is an equal employment opportunity employer valueing a diverse workforce, aiming to attract, develop, and retain top talent to serve the citizens of Pennsylvania. Embracing inclusion, the Commonwealth does not discriminate based on various categories protected by law. Diverse applicants are encouraged to apply.

EXAMINATION INFORMATION

  • Completing the application and supplemental questions constitutes the exam for this position. No additional test necessary.
  • Your score is determined by the information provided in your application and responses to supplemental questions.
  • Score valid for this specific posting only.
  • Provide accurate and detailed information to ensure fair scoring.
  • One application/test allowed per posting.
  • Results will be communicated via email.

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