Job description
Description
Medical Assistance Specialist 3 (MCS/MEDS)- Facility Based
71036582
This is an excellent opportunity to gain state experience while doing rewarding work by helping provide comprehensive health coverage to more than 2 million Washingtonians. Join HCA in making a difference!
About the division:
The Division of
Medicaid Customer Service (MCS) works across the Health Care Authority (HCA) and in partnership with the health care community at a local, state, and federal levels, to develop, and manage high quality, and evidence-based health care programs and purchase services that enhance Apple Health (Medicaid) clients' ability to access appropriate, quality health care.
About the position:
The Medical Assistance Specialist 3 (MCS/MEDS) supports the HCA mission to provide access to medical care for all eligible Washington citizens. This position works out of our partner facility in Sunnyside, Washington. The position determines initial eligibility and/or ongoing individual and family medical eligibility for Medicaid Title XIX, Children’s Health Insurance Program (CHIP) Title XXI program, and other Medicaid and state funded medical assistance programs available in Washington State.
The position is eligible for part-time telework (after probationary period has ended) and is dual-language preferred, but not required.
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. Frequency of onsite work will vary based on business and operational needs. HCA may choose, but is not required, to support out-of-state telework on a case-by-case basis.
Duties
Some of what you will do:
- In the Medicaid Customer Service (MCS) division, independently analyze applications, determine initial and/or ongoing eligibility and authorize benefits for Medicaid programs administered by the Medical Eligibility Determination Services (MEDS) office.
- Apply complex federal and state eligibility regulations published in WAC and RCW to specific household circumstances resulting in accurate eligibility decisions.
- Use and manage multiple interdependent electronic systems including but not limited to the Automated Client Eligibility System (ACES), HealthPlanFinder, ProviderOne, Audit Plus, Microsoft Office, SOLQ, Document Management System (DMS) and Employment Security Department (ESD).
- Conduct interviews over the telephone, in person, and/or through written correspondence with clients, providers and/or third parties to obtain information for required documentation and verification to support program eligibility. Establish effective working relationships with clients and their advocates and manage difficult interactions with tact and diplomacy.
- Work with individual Take Charge providers to answer inquiries and resolve issues related to eligibility for the Take Charge Family Planning program.
- Answer inquiries, resolve questions, update eligibility records, and otherwise maintain and expand access to medical care for eligible Washington citizens.
- Work in partnership with advocates, providers, Heath Benefit Exchange, other state agencies, community-based organizations, and other units within HCA to provide clarification, resolve disputes, solve problems, coordinate referrals and/or answer inquiries.
Qualifications
Required qualifications:
Qualified candidates will meet one of the following criteria:
- A bachelor’s degree AND one (1) year of the experience as defined below.
OR
- An associate's degree AND three (3) years of the experience as defined below.
OR
- A Certificate of Medical Billing and Coding or closely related certificate program AND three (3) years of the experience as defined below.
OR
- Five (5) years of the experience as defined below.
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.
- Experience researching and analyzing complex rules, regulations, or policies and utilizing research and analysis to make determinations, solve problems, or complete work while providing direct customer service either in person or on the telephone.
Preferred qualifications:
- Experience performing conflict resolution with customers.
- Knowledge of Medicaid programs and eligibility.
- Experience utilizing Microsoft Office programs such as Outlook, Word, and SharePoint.
Supplemental Information
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 and attach:
A cover letter that specifically addresses how you meet the qualifications for this position.- Current resume.
- Three professional references.
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.
About HCA:
The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.
HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, and the School Employees Benefits Board (SEBB) Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.
What we have to offer:
The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.
HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, and the School Employees Benefits Board (SEBB) Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.
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:
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. Our diversity and inclusion efforts include embracing different cultures, backgrounds and viewpoints while fostering growth and advancement in the workplace. Women, racial and ethnic minorities, persons of disability, persons over 40 years of age, disabled and Vietnam era veterans, as well as people of all sexual orientations and gender identities are encouraged to apply. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Angel Matthews at angel.matthews@hca.wa.gov.
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.
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