Medicaid Program Associate - PCN 064064

State of Alaska • Anchorage, AK

15h • Hybrid

About The Position

This Individual Position is Exempt from the Hiring Freeze. Qualified Applicants are Encouraged To Apply. Welcome to the Department of Health! We’d be delighted to have you join our team. If you envision yourself in this role and are ready to start an exciting career with us, apply today! This position is open to Alaskan Residents only. Please check out the residency definition to determine if you qualify. As the Medicaid Program Associate, you will play a key role in ensuring Medicaid uses the right funding sources by keeping third-party insurance information accurate and up to date. You will solve interesting coverage and claims puzzles by researching insurance details, analyzing data, and resolving issues that impact beneficiaries and providers. You will work closely with staff, contractors, and major insurance carriers to coordinate benefits and keep the Medicaid program running smoothly. You'll be responsible for reviewing and investigating complex claims to determine correct payment decisions, protecting Medicaid resources, and playing an active role in protecting Medicaid resources by assisting the TPL Recovery team with accurate, high-impact data entry work. The division is focused on ensuring Medicaid remains the "payer of last resort" by accurately identifying, coordinating, and recovering from all available third-party resources. Its mission emphasizes program integrity, fiscal responsibility, and compliance with state and federal requirements to safeguard Medicaid funds. This position directly supports that mission by maintaining accurate TPL data, resolving complex insurance issues, and ensuring all liable parties are billed before Medicaid pay.

Requirements

• Technical Credibility – Understands and appropriately applies principles, procedures, requirements, regulations, and policies related to specialized expertise.
• Attention to Detail – Is thorough when performing work and conscientious about attending to detail.
• Analytical Thinking/Problem Solving - uses a logical, systematic, sequential approach to address problems or opportunities or manage a situation by drawing on one’s knowledge and experience base and calling on other references and resources as necessary.
• Customer Service: Anticipates and meets the needs of both internal and external customers. Delivers high-quality products and services; is committed to continuous improvement.
• Oral Communication: Expresses information (for example, ideas or facts) to individuals or groups effectively, taking into account the audience and nature of the information (for example, technical, sensitive, controversial); makes clear and convincing oral presentations; listens to others, attends to nonverbal cues, and responds appropriately.
• Written Communication: Writes in a clear, concise, organized, and convincing manner for the intended audience.
• Experience applying program requirements and working with individuals in stressful situations and/or training or education, which includes such coursework as business administration, computer sciences, economics, healthcare, legal studies, medical billing or coding, public health, public assistance, psychology.

Nice To Haves

• Some or all of the following position-specific competencies: Technical Credibility, Attention to Detail, Analytical Thinking/Problem Solving.

Responsibilities

• Ensuring Medicaid uses the right funding sources by keeping third-party insurance information accurate and up to date.
• Solving coverage and claims puzzles by researching insurance details, analyzing data, and resolving issues that impact beneficiaries and providers.
• Working closely with staff, contractors, and major insurance carriers to coordinate benefits and keep the Medicaid program running smoothly.
• Reviewing and investigating complex claims to determine correct payment decisions.
• Protecting Medicaid resources by assisting the TPL Recovery team with accurate, high-impact data entry work.
• Maintaining accurate TPL data.
• Resolving complex insurance issues.
• Ensuring all liable parties are billed before Medicaid pay.

Benefits

• Opportunities for professional growth through hands-on experience with Medicaid policy, third-party liability coordination, and cross-division collaboration.
• Support for career development with training, knowledge-building, and exposure to complex program processes.
• Flexible scheduling.
• Potential telework options.
• Meaningful work that protects program integrity, ensures Medicaid dollars are spent responsibly, and directly supports vulnerable Alaskans.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed