Lobby - Medical Assistance Specialist 3 (MAS3/AHEA)

State of Washington • Thurston County – Olympia, WA

9d • Onsite

About The Position

The Medical Assistance Specialist 3 works in the Medical Eligibility Determination Services (MEDS) office within the Washington State Health Care Authority’s Apple Health Eligibility and Access (AHEA) Division. The position independently determines eligibility for Apple Health (Medicaid), the Children’s Health Insurance Program (CHIP), and other state-funded medical assistance programs. It applies federal and state eligibility rules to individual household circumstances and authorizes benefits. The role serves the public face-to-face in an HCA lobby office, by phone, and in writing, and partners with providers, advocates, agencies, and community organizations to answer questions and resolve issues.

This is a full-time, permanent, in-person position based in Olympia, Washington. The standard schedule is Monday through Friday, 8 a.m. to 5 p.m., with alternative schedules considered based on business needs. The position works in a shared, open-office environment, and occasional travel may be required for meetings, training, or other business needs. Employees must be Washington residents by their first day and report to the Olympia office on their first and final days of employment.

The role is part of a collaborative team that provides ongoing training and supports process improvement. The AHEA Division works with the Health Care Authority and health care partners at local, state, and federal levels to develop and manage health care programs and purchase services that support Washington residents’ access to appropriate, quality care.

Requirements

• Demonstrated ability to interpret and apply regulations, policies, and procedures.
• Demonstrated ability to independently research, analyze, and evaluate complex information to make accurate determinations and resolve program-related issues within established authority.
• Demonstrated ability to identify, analyze, and resolve complex issues.
• Demonstrated ability to research and interpret complex program rules, regulations, policies, procedures, and other authoritative information, and apply findings to individual circumstances.
• Demonstrated experience providing accurate technical information, consultation, and assistance to customers, providers, members, and other partners regarding complex issues and requirements.
• Demonstrated ability to communicate complex or technical information clearly, accurately, and professionally, verbally and in writing, to people with varying levels of program knowledge.
• Demonstrated ability to independently produce accurate, complete, and timely work while ensuring compliance with applicable laws, regulations, policies, procedures, and program standards.
• Demonstrated ability to independently organize and prioritize complex assignments, manage competing demands, meet established timelines, and exercise sound judgment with limited supervisory direction.
• Ability to consider equity in decisions, processes, and daily work.
• Ability to learn and grow by seeking new perspectives, learning from experience, and using lessons learned to improve work and service.
• Ability to meet the needs of others by listening, understanding different perspectives, and responding with care, respect, and helpful solutions.
• Washington state residency by the first day of employment.
• Experience may be gained through paid or unpaid activities; relevant experience must be described in the cover letter, resume, and application.

Nice To Haves

• Demonstrated ability to resolve customer conflicts in person professionally and effectively while maintaining positive working relationships.
• Ability to use Microsoft Office applications, including Outlook, Word, and SharePoint, to support business operations and communication.
• Experience as a Medical Assistance Specialist 2 or Medical Assistance Specialist 3.
• Ability to apply knowledge of Medicaid programs and eligibility requirements in assigned work.
• A bachelor’s degree in a related field.
• Professional experience providing direct client services or customer counseling in health insurance, disability, or related health benefits; public assistance eligibility determination; health insurance premiums or claims processing, adjusting, or investigation; other medical premiums, claims, or eligibility-related work; or researching and analyzing complex rules, regulations, and policies to make determinations and resolve problems while providing direct customer service.

Responsibilities

• Independently determine initial and ongoing eligibility for Medicaid Title XIX, CHIP Title XXI, and other Medicaid and state-funded medical assistance programs administered by MEDS.
• Apply complex federal and state eligibility rules, including WAC and RCW, to household circumstances and make accurate eligibility decisions and authorize benefits.
• Research and resolve complex eligibility issues with a high degree of independence.
• Use interconnected systems, including the Automated Client Eligibility System (ACES), Washington Healthplanfinder, ProviderOne, and the Document Management System (DMS).
• Interview clients, providers, and third parties by phone, in person, and in writing to obtain documentation and verification needed to support eligibility.
• Provide direct, face-to-face customer support to the public in an HCA lobby office.
• Partner with advocates, providers, the Health Benefit Exchange, other state agencies, and community-based organizations to answer questions, resolve disputes, and coordinate referrals.
• Support Take Charge family planning providers with eligibility questions.
• Participate in process improvement efforts to streamline MEDS operations.
• Organize and prioritize complex assignments, manage competing demands, meet timelines, and exercise sound judgment with limited supervisory direction.
• Consider equity in decisions, processes, and day-to-day work, and respond to the needs of customers and communities with care and respect.

Benefits

• Medical, dental, vision, and basic life insurance
• Paid vacation and sick leave
• 12 paid holidays
• Paid Family and Medical Leave (PFML)
• Retirement options
• Training and professional development opportunities
• Employee wellness programs
• Remote work and flexible schedules are listed among HCA employee benefits, though this position is specifically described as in-person.

What This Job Offers

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