Third Party Liability Specialist

Commonwealth of Pennsylvania•Dauphin County, PA

12h•Hybrid

About The Position

As a Third Party Liability Specialist with the Department of Human Services (DHS), you will help ensure that medical assistance funds are used responsibly. This position allows you to solve problems, review detailed information, and work with partners statewide. You will contribute to important efforts that protect public programs and keep systems running smoothly. Your dedication will make a real impact on communities across Pennsylvania! This position supports the Bureau of Program Integrity’s recovery of medical assistance expenditures that were incorrectly or provisionally paid. The work helps ensure the accurate use of funds and strengthens DHS operations.

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 three months of graduating with a qualifying degree.
You must meet the PA residency requirement.
You must be able to perform essential job functions.

Responsibilities

Evaluate potential cash and medical assistance claims by reviewing referrals and identifying responsible parties
Gather information from attorneys, insurance representatives, providers, and others to verify and support DHS claims
Understand and apply relevant laws, policies, and regulations to ensure accurate management of cash and medical benefit cases
Coordinate with internal units and external agencies to support effective claim collection
Examine case records and electronic data systems to maintain accuracy and support claim decisions
Make well-reasoned decisions to resolve claims while protecting the interests of DHS