Health Ombudsman

State of Maryland•Baltimore City, MD

7d•Onsite

About The Position

The Attorney General is the chief legal officer of the State of Maryland. The Office of the Attorney General (OAG) has the general charge, supervision, and direction of the State’s legal business, acting as legal advisors and representatives of the major agencies, various boards, commissions, officials, and institutions of State Government. The OAG also protects the public by civil enforcement of antitrust, civil rights, consumer protection, and securities laws and regulations and by the prosecution of organized crime, Medicaid fraud, environmental crimes, insurance fraud, state tax evasion, and other statutorily assigned matters. As Maryland’s 47th Attorney General, Anthony G. Brown leads the Office with a critical focus on equity, justice, and fairness. The Consumer Protection Division Health Education and Advocacy Unit (HEAU) is seeking a dedicated and compassionate individual to join our team as an Ombudsman. HEAU plays a vital role in protecting and empowering Maryland consumers by: Assisting individuals in resolving billing disputes with health care providers and insurers. Helping consumers navigate health insurance coverage denials and appeals. Educating the public about their healthcare rights and responsibilities. Advocating fair and equitable access to healthcare services. The Unit receives approximately 2,000 consumer complaints, 4,500 hotline calls, and 6,000 emails each year, reflecting the high volume and critical nature of our work. The team is comprised of two attorneys, two case managers, an administrative assistant, and eight ombudsmen. We also work with a dedicated group of volunteers, interns, and law clerks who support our mission year-round. Join our team to help Marylanders resolve complex health care issues to ensure fair access to care for all.

Requirements

Graduation from an accredited high school or possession of a high school equivalency certificate.
Three years of administrative or professional work.
Strong written and verbal communication skills
Excellent organizational and time management abilities
Proficiency in Microsoft Office and database software
Knowledge of HIPAA and healthcare privacy regulations
Empathy and patience when working with consumers under stress.
Candidates may substitute 30 college credit hours from an accredited college or university for each year up to two years of the required experience.
Candidates may substitute the possession of a Bachelor's degree from a college or university for the required experience.
Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer.

Nice To Haves

Bachelor’s degree in nursing, healthcare administration, public health, social work, or a related field or associate’s degree with relevant experience.
2+ years of experience in health law, health insurance, medical billing, claims processing, or patient advocacy.
Familiarity with insurance denial codes, appeal processes, and payer-specific guidelines.
Experience working in a healthcare setting, nonprofit, or consumer advocacy organization.
Leading teams in supervisory roles.

Responsibilities

Review and analyze denied insurance claims to determine the basis for denial.
Assist consumers in understanding their rights and appeal options.
Prepare and submit written appeals with supporting documentation.
Assist consumers with a range of healthcare-related concerns, including billing disputes; financial assistance; and coverage issues.
Communicate with insurance companies, healthcare providers, and patients to gather necessary information.
Track all complaint and appeal statuses and ensure timely follow-up.
Maintain accurate records of all complaints and correspondence.
Stay current with healthcare regulations, payer policies, and appeal procedures.
Educate consumers on the appeals process and advocate on their behalf.
Respond to inquiries via the HEAU hotline.
Supervise and mentor volunteers and interns assisting with complaint resolution.
This role involves frequent interaction by phone and in writing with consumers, providers, and insurers.
It’s an opportunity to help people resolve real-world problems and protect Maryland’s most vulnerable residents from unfair and deceptive practices.