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Medicaid Claims Management Specialist
2 months ago
Position Overview:
As a Medicaid Program Specialist 3, you will play a crucial role in overseeing quality assurance and contract management related to Medicaid claims processing and information systems.
Key Responsibilities:
In this capacity, you will:
- Lead the team in the management of Medicaid pharmacy claims processing systems.
- Serve as the primary expert on financial claims processing and accounting functions.
- Oversee payment processing functions within the Medicaid Management Information System (MMIS), ensuring compliance with IRS requirements.
- Monitor and implement federal and legislative mandates, as well as executive branch initiatives that necessitate coordination of MMIS development efforts.
Minimum Qualifications:
Applicants should possess a combination of education and experience that demonstrates the following competencies:
- Analytical Thinking: Employ a logical and systematic approach to problem-solving.
- Effective Communication: Clearly articulate information to various audiences.
- Technical Proficiency: Utilize technical knowledge to address a variety of challenges.
- Written Communication Skills: Compose clear, concise, and organized written materials.
This role requires experience in areas such as Medicaid or Medicare program administration, health insurance services, health insurance management information systems, or auditing medical assistance programs for compliance and quality assurance.
Application Requirements:
Interested candidates must submit a cover letter detailing their qualifications and relevant experience. Additionally, during the interview process, candidates should be prepared to provide:
- Three professional references, including one from a current or recent supervisor.
- A current performance evaluation, if available.
- A copy of academic transcripts (unofficial copies are acceptable).
Note: A cover letter is mandatory and should reflect your knowledge, skills, and abilities as they relate to this position.
