Medical Assistance Program Technician
About The Position
The Medical Assistance Program Technician works in the Bureau of Program Integrity, Division of Third Party Liability, Recovery Section, Statement of Claim Creation Unit. The position reviews, analyzes, calculates, and summarizes medical claims to support accurate and timely creation and processing of statements of claims across medical and financial situations. The technician reviews claims involving personal injury and decedent estate cases, gathers information from facilities and agencies, calculates medical and cash payment amounts using applicable federal standards, interprets managed care encounter data, updates claims, and applies federal and state regulations and policies. This is a full-time position with work hours of 8:00 AM to 4:00 PM, Monday through Friday, with a 30-minute lunch. Free parking is available. Part-time telework, up to three days per week, may be available from an approved location within Pennsylvania, subject to having a securely configured high-speed internet connection and to change at any time. Employees unable to telework may report to the headquarters office in Harrisburg.
Requirements
- Three years of para-technical experience involving reviewing and responding to inquiries related to applicable services or benefits in health care insurance programs, health care services, or medical assistance program services; or an equivalent combination of experience and training.
- Must meet the Pennsylvania residency requirement.
- Must be able to perform the essential job functions.
Responsibilities
- Independently review complex medical claims to determine which relate to specific personal injury or decedent estate cases.
- Contact facilities and agencies, and analyze correspondence and forms, to obtain required information.
- Calculate and update medical and cash payment amounts, determining cash received using standards permitted by federal law.
- Review and interpret complex client encounter data from managed care organizations to explain fiscal processes that determine amounts due and owed.
- Identify claim adjustments and create and update statements of claims.
- Apply federal and state regulations and policies to identify and follow proper procedures independently.
Benefits
- Free parking
- Potential part-time telework, up to three days per week
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
