Financial Representative 2

Description of Work/Duties:

Consultant will work with the Department of Human Services, Office of Medical Assistance Programs (Department). This is a professional level position responsible for various operational aspects of the Fee-for-Service Medical Assistance program. Consultant will perform a wide range of duties depending on the Division within the Bureau the position is assigned:

Possess a bachelor's degree. A combination of education and experience will be considered;

Be available as a consultant on average 37.5 hours per week;

Possess the ability to work as part of a workgroup or team for the unit's assigned projects. General research and on-line computer research skills are required;

Understand and be familiar with the operation of human service governmental operations at the federal, state, county and local levels. Project troubleshooting and problem-solving skills are required;

Possess basic computer skills, including familiarity with Microsoft Office programs.

For Division of Clinical Review, the Financial Representative 2 consultant duties include:

· Access and log Medical Assistance provider-submitted prior authorization requests and forward to designated nurse reviewers for clinical determinations.

· Field inquiries and coordinate with designated clinical staff for their resolution.

· Act as a backup for scheduling calls for designated nurse reviewers to external providers.

· Other administrative duties, as assigned.

For the Division of Provider Enrollment, the Financial Representative 2 consultant duties include:

· Field inquiries to answer a full spectrum of provider participation questions including requirements for enrollment in the Medical Assistance program based on provider types and specialties, conditions of participation and the enrollment process.

· Screen and process provider enrollment applications,

· Inform provider applicants of error, omissions and corrections needed to process MA enrollment applications and process notices to providers.

· Conduct required background clearance checks.

· Verify information captured in MA enrollment application is present in provider file in the Medical Assistance Information System.

· Responsible for the timeliness and accuracy of information posted to the Department's website relating to provider enrollment.

· Attends and conducts workgroups responsible for developing, recommending and implementing changes to policies and procedures that affect the provider enrollment process. Implement executive decisions.

· Participate in team meetings, receive updates on system changes or new policies.

· Perform work on provider Medical Assistance error reports as assigned.

Consultant, when requested, will work at one or more of the Department's work sites. Consultant's primary work station will be at the Commonwealth Towers located at 333 Walnut Street in Harrisburg, PA. Consultant will be provided with a desk, computer, phone, and all items necessary for him/her to complete assignments. If Consultant is unable to appear at the scheduled work site at the pre-determined times, notification must be made to the Work Site Supervisor either prior to date or on date of absence.

Consultants will be evaluated on:

· Quality of work product;

· Appropriateness of work habits;

· Growth of knowledge base and skill set;

· Effectiveness of communications;

· Initiative and problem-solving skills;

· Contributions to a productive and hospitable work environment;

About Us:

TulaRay partners with clients to create staffing solutions that meet unique organizational needs. Our services are designed to reduce administrative burdens, protect your brand, and improve assignment time-to-fill. We believe that mutually successful client relationships are built on lasting quality and exceptional customer service. We pride ourselves on our uncompromising commitment to high-quality emergency management & healthcare personnel, while ensuring that our clients are taken care of with personalized attention. TulaRay manages total compliance and respectfully supports hundreds of professionals and patient-centered programs.

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