Third Party Liability Specialist

Commonwealth of Pennsylvania•Dauphin County, PA

6d•Hybrid

About The Position

The Third Party Liability Specialist role with the Department of Human Services gives you the chance to drive real change across Pennsylvania. You join a team that protects public resources and strengthens the fairness of medical assistance programs. This position helps you build valuable skills while taking on important challenges that keep statewide services strong. Step into a role where your efforts make a clear and lasting impact for communities throughout the Commonwealth. This position focuses on reviewing and analyzing claims to ensure that medical assistance funds were used appropriately. You support the integrity of statewide recovery efforts by investigating cases and coordinating with many partners. As a Third Party Liability Specialist, you will perform the following duties: Claim Review: Assess referrals to determine whether medical assistance benefits were granted in error and identify responsible parties Case Investigation: Conduct investigations of personal injury and estate matters through communication with attorneys, providers, and other agencies Legal Research: Develop knowledge of laws and regulations that apply to cash and medical benefit claims and apply that information to your work Interagency Coordination: Work with other units and external offices to support efficient claim collection processes Settlement Negotiation: Evaluate case factors to negotiate fair settlements using skilled diplomacy to maximize collections Record Management: Maintain accurate case records and review payments to ensure proper crediting

Requirements

Four years of technical experience collecting, reviewing, or evaluating information for program eligibility or insurance limits of liability; or A bachelor’s degree; or An equivalent combination of experience and training.
Applicants will be considered to have met the educational requirements once they are within 3 months of graduating with a qualifying degree.
You must meet the PA residency requirement.
You must be able to perform essential job functions.

Responsibilities

Assess referrals to determine whether medical assistance benefits were granted in error and identify responsible parties
Conduct investigations of personal injury and estate matters through communication with attorneys, providers, and other agencies
Develop knowledge of laws and regulations that apply to cash and medical benefit claims and apply that information to your work
Work with other units and external offices to support efficient claim collection processes
Evaluate case factors to negotiate fair settlements using skilled diplomacy to maximize collections
Maintain accurate case records and review payments to ensure proper crediting