Third Party Liability

3 weeks ago

Helena, United States State of Montana Full time
Third Party Liability (TPL) Recovery Specialist-(24141137)

The Montana Department of Public Health and Human Services (DPHHS) has a career opportunity within the Office of Inspector General/Program Compliance Division.

This position works as part of a team that identifies, negotiates, and collects funds from liable third parties, estates, and public assistance members to ensure the integrity and cost-effectiveness of programs administered by the department.Responsibilities include examination of paid claims, contacting appropriate parties for information, calculating liability and financial recovery.Other responsibilities include tracking and reporting recovery funds into software systems, filing claims and liens, negotiating settlements, and determining the cost effectiveness of Medicaid members having private insurance via the Health Insurance Premium Program (HIPP).

Why Join DPHHS

Our mission at DPHHS is to serve Montanans in their communities to improve and protect the health, safety, and well-being, and to empower independence. By joining our department, you will have the opportunity to perform meaningful work in public service to our state and its residents.

The State of Montana's comprehensive benefits package includes healthcare coverage, retirement plans, paid vacation, sick leave, and holidays, work/life balance, and eligibility to participate in the Public Service Loan Forgiveness (PSLF) program. In addition, DPHHS is the largest state agency with a wide range of advancement opportunities whether you are joining the workforce or have several years of experience.

Qualifications for this Career Opportunity

·General understanding of the Medicaid program to include public assistance eligibility, claims processing, cost-avoidance functions, and insurance resources.

·Interpersonal, oral, and written communication skills and techniques.

·Ability to gather, verify, and analyze claims and financial data.

·Ability to analyze claims, insurance policies, benefits, and apply third party liability procedures to resolve complex problems.

·Ability to use reason and logic to identify and solve problems.

·Ability to interpret complex policies, laws, and rules.

·Ability to operate a personal computer and general office equipment including using spreadsheets, word processing, database, email, internet, and other computer programs.

Meet minimum qualifications:

oBachelor’s degree in social sciences, accounting, healthcare, business, or related degree.

oTwo years of experience with health care reimbursement, analyzing cost reports, interpreting, and analyzing laws, rules, regulations, and standards affecting reimbursement and recovery.

oEquivalent combinations of directly related education and experience may be considered on a case-by-case basis.

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