Medical Assistance Specialist 3 (MAS3/DAIO) – Project/Internal

Description

 
 
This position supports Medicaid providers by fielding requests and inquiries via phone, managing applications, and updating information in the ProviderOne system. This position requires exceptional customer service and adaptability to changes in processes and policies. The ideal candidate will have a strong track record of customer service, managing complex systems, and adapting to changes in policies and procedures.
 
All HCA employees will apply an equity lens to their work, which may include but is not limited to all analyses of core business and processes.
 
About the position:
In a customer service environment this position enrolls providers into the State’s Medicaid ProviderOne System to allow providers to bill for services and items for Medicaid clients. This position also revalidates and reviews updates from enrolled providers to ensure providers continue to meet eligibility requirements and are in good standing. This position supports the mission of Provider Enrollment within the Health Care Authority by working to:

• Ensure only qualified providers are enrolled with HCA and provider eligibility requirements are met for each specialty;
• Ensure federal, state, and other applicable regulations and procedures and policies are followed; and
• Ensure applications and related work is approved in a timely manner.

This position answers calls on the toll-free lines and replies to other types of correspondence providing consultative services to providers and external customers regarding enrollment, terminations, re-enrollment, changes of information in the provider files, and billing problems pertaining to provider enrollment. The consultative services provided by PE require staff to analyze issues, evaluate what needs to be done, and determine how to best address the issue.
 

This position is eligible to telework and is typically not required to report on-site. The default assigned work location of all Health Care Authority (HCA) positions – both on-site and telework eligible positions – is within the State of Washington. This position reports to Olympia, WA. Frequency of onsite work will vary based on business and operational needs. HCA has currently suspended the ability to support out-of-state telework. 

Duties

Some of what you will do:

• Approves provider revalidations, updates, and related activities. Determines provider eligibility for medical assistance programs. Implements policy and assures applicable regulations are followed.
• Reviews for completeness and ensures all required fields including disclosure requirements are filled out by the provider. 
• Performs database checks on the revalidating providers, the ownership, managing employees, and controlling interests. 
• Ensures site visits are made when required. 
• Contacts and counsels providers on applicable policies and procedures related to revalidations and provider updates.
• Answers calls on the toll-free lines and responds to other types of correspondence including ServiceNow tickets for emails, faxes, and U.S mail as well as Seibel service requests. 
• Analyzes records, cases, and situations, and evaluates what needs to be done. Determines how to best address issues and makes timely, accurate decisions to assist providers with complex provider enrollment issues. 
• Addresses provider enrollment related issues which cause billing problems. 
• Enters comments and required checklists documenting the application directly into ProviderOne as required in the manual. 
• Images all documents related to the application into ProviderOne, including results of database checks and application forms.

Qualifications

Required qualifications:

Qualified candidates will meet one of the following criteria combinations:

Option 1:

• Bachelor’s degree and 
• One year of the experience as defined below.

Option 2:

• Associate degree and 
• Three years of the experience as defined below.

Option 3:

• Certificate of Medical Billing and Coding or related certificate and 
• Three years of the experience as defined below.

Option 4:

• Five years of the experience as defined below.

Option 5:

• One year as a Medical Assistance Specialist 2.

The experience required is one or a combination of the following:

• providing direct client services or counseling of customers in the areas of health insurance, disability, or other related health benefits; 
• public assistance eligibility determination; 
• health insurance premiums/claims processing, adjusting, and investigation; or
• other medical premiums/claims/eligibility related experience.

Preferred qualifications:

• One or more years of work experience:
  • providing customer service,
  • in medical groups and/or facilities, 
  • utilizing ProviderOne with providers, and/or
  • with provider credentialing.
• Computer skills, knowledge of ProviderOne billing system and Siebel Information storage system.
• Ability to learn and utilize multiple systems and web based tools simultaneously to accomplish tasks.
• Knowledge of Medicaid programs. 
• Ability to manage information arising out of conflicting rules and procedures that are established by other sections over which they have no control. 
• Ability to manage stress arising out of diverse conflicts and the demands of customers to provide the correct resolution of issues within a short period. 
• Ability to counsel and placate customers’ expectations when they are different from the policy and regulations under WAC. 
• Ability to consistently provide excellent customer service during a full shift of continuous phone calls.

How to apply:

Only candidates who reflect the minimum qualifications on their NEOGOV profile will be considered. Failure to follow the application instructions below may lead to disqualification. To apply for this position, you will need to complete your profile which includes three professional references and attach:

• A cover letter that specifically addresses how you meet the qualifications for this position
• Current resume 

To take advantage of veteran preference, please do the following:

• Attach a copy of your DD214 (Member 4 long-form copy), NGB 22, or USDVA signed verification of service letter. 
• Please black out any PII (personally identifiable information) data such as social security numbers. Include your name as it appears on your application in careers.wa.gov. 

Supplemental Information

 
About HCA: 
Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.
 
There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.
  
What we have to offer:

• Meaningful work with friendly co-workers who care about those we serve Voices of HCA 
• A clear agency mission that drives our work and is person-centered HCA's Mission, Vision & Values
• A healthy work/life balance, including alternative/flexible schedules and mobile work options.
• A great total compensation and benefit package WA State Government Benefits
• A safe, pleasant workplace in a convenient location with restaurants, and shopping nearby. 
• Tuition reimbursement
• And free parking! 

 
Notes:
This position is covered by the Washington Federation of State Employees (WFSE). Once the listed position(s) is(are) filled, this recruitment announcement may also be used to fill additional position(s) for up to sixty (60) days.
 
Prior to a new hire, a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment.
 
HCA is an equal opportunity employer. We value the importance of creating an environment in which all employees can feel respected, included, and empowered to bring unique ideas to the agency. HCA has five employee resource groups (ERGs). ERGs are voluntary, employee-led groups whose aim is to foster a diverse, inclusive workplace aligned with HCA’s mission. Our diversity and inclusion efforts include embracing different cultures, backgrounds and viewpoints while fostering growth and advancement in the workplace. Studies have shown women, racial and ethnic minorities, and persons of disability are less likely to apply for jobs unless they feel they meet every qualification as described in a job description. Persons over 40 years of age, disabled and Vietnam era veterans, as well as people of all sexual orientations and gender identities are also encouraged to apply. If you have any questions about the required qualifications or how your experience relates to them, please contact us at [email protected]. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Jake Nelko at 360-725-0945 or [email protected]. 
 
The Washington State Health Care Authority (HCA) is an E-Verify employer. All applicants with a legal right to work in the United States are encouraged to apply.
 
 

E-Verify® is a registered trademark of the U.S. Department of Homeland Security.