Washington State Medical Assistance Specialist 3 in Tumwater, Washington
Medical Assistance Specialist 3 (MAS3)** Health Services Contracts, Claims and Benefits Unit Health Services Division Headquarters – Tumwater, WA
Salary*: Range 42, $2,925 - $3,807 (Monthly)**
*Salary is dependent upon candidate qualifications. The Appointing Authority (AA) may authorize additional compensation, not to exceed 15% above the published salary for recruitment and retention difficulties.
This position is open until filled. The initial review date will be held on October 14, 2016; therefore, it is in the applicant's best interest to submit application materials as soon as possible. The employer reserves the right to make a hiring action at any time.
The Department of Corrections (DOC) is seeking a highly motivated and qualified individual for a Medical Assistance Specialist 3 in the Health Services Contracts, Claims and Benefits Unit within the Health Services Division. This is a full-time, permanent position located at DOC Headquarters in Tumwater, Washington.
If you are interested in applying and would like to be considered, please apply directly at careers.wa.gov and attach the following documents:
- Current Resume, (chronological, with relevant experience listed).
- Minimum of three (3) professional references, (including name, phone number and email address).
- Letter of Interest, (no more than two (2) pages), indicating how you meet the qualifications and why you believe you are the ideal candidate for this position. We are looking for evidence in your application materials that you have the experience, skills, and abilities indicated in this job posting. Qualified applicants whose responses most closely match the requirements of this position may be invited to interview. Carefully review your application before submitting. All information may be verified and documentation may be required. The initial screening will be solely based on the contents and completeness of the application materials submitted.
Whether the work is inside a prison, in community corrections, or in an administrative office, the Washington State DOC professional staff experience a high degree of personal satisfaction knowing they are creating environments in which all offenders can learn to make choices that contribute to a safer society.
The DOC, as a partner in the criminal justice system, enhances public safety, administers criminal sanctions and programs in accordance with the law, and provides leadership for the future of corrections in Washington State. The DOC consists of the Office of the Secretary, the Office of the Deputy Secretary, Prisons Division, Offender Change Division, Community Corrections Division, Administrative Operations Division, Health Services Division, Correctional Industries Division, Reentry Division and the Indeterminate Sentence Review Board. The DOC employs over 8,300 staff and has a biennial budget of approximately $1.9 billion.
- Comprehensive compensation packages;
- Training and development opportunities;
- Flexible Schedules; and
- The fulfillment of public service. Duties
As a member of the Health Services Contracts, Claims and Benefits Unit, you will provide technical support by ensuring timely and accurate processing of claims for medical services provided to offenders. You will help ensure that relationships between vendors providing goods/services and the Department are in good standing.
As an expert, you will determine processing or denials of provider's claims submitted to the Department by deciphering and interpreting information on claims/adjustments requests submitted. Additionally, you will adjudicate claims adjustments through the ProviderOne system as well as standard, manual paper process.
Some of what you'll do:
- Review, authorize, or deny payment of bills from medical service providers for DOC offenders
- Determine whether or not items billed were authorized by the Department in compliance with the Offender Health Plan, utilizing the ProviderOne payment system and standard manual claims processing.
- Analyze medical billings International Classification for Diseases (ICD-10) code and Current Procedural Terminology (CPT)/Healthcare Common Procedural Coding System (HCPCS) code to ensure accurate billing.
- Verify inpatient or outpatient status and follow appropriate procedures for each status. Verify that services were provided while offender was in DOC's custody.
- Adjudicate complex medical claims; research, resolve, initiate and process appropriate adjustments.
- Respond to complex complaints, problems or conflicts to include but not limited to: duplicates, authorizations, sterilizations/vasectomy and surgery claims.
- Perform in-depth research and analysis of medical reports and reviews; access and review history profiles for recipients and/or providers.
- Manually price claims submitted to DOC by applying various reimbursement methodologies customarily used in medical billing. Qualifications
- One (1) year of experience as a Medical Assistance Specialist 2 or equivalent.
- Knowledge and understanding of various health care coding structures (CPT, HCPCS, ICD-9, ICD-10 etc.)
- Intermediate-level proficiency with Microsoft Excel, Word and Outlook. (Recent experience in claims processing, adjusting, and investigation; or other medical premiums/claims related experience may substitute, year-for-year for the required experience.)
Knowledge, Skills and Abilities:
- Demonstrated ability to adapt to change quickly.
- Demonstrated time management skills.
- Demonstrated ability to prioritize effectively to meet workload demands.
Demonstrated 10-key skills. Desired*:*
Minimum of one (1) year of experience processing, adjusting, investigating, and/or adjudicating of various types of health insurance premiums/claims.
- Certified Professional Coder.
- Demonstrated experience processing claims in ProviderOne system. Supplemental Information
'The mission of DOC is to improve public safety.'
For additional information about the agency, please visit www.doc.wa.gov.
- All DOC employees are fingerprinted for a criminal history background check.
- Employees may work with offenders in a potentially hazardous setting. Please consider this when deciding whether to apply.
- We are committed to maintaining a drug and alcohol free work environment, and our employees are expected to comply with all state and federal laws. A pre-employment drug test may be administered as part of the selection process, and applicants who test positive for any controlled substances, including marijuana, will be disqualified from consideration.
- Animal care projects are a common component of most Washington State prisons, including dog and cat programs. Applicants with animal sensitivities or allergies are encouraged to ask about the level of exposure they could expect in this position.
- Tuberculosis is a priority health issue for DOC employees. The successful candidate may be required to provide valid proof of a baseline TB skin test within 60 days from the date of hire. When positive tests result, further information, testing and treatment may also be required. Employment is not contingent upon test results. We are committed to hiring individuals who possess core diversity competencies:
- Foster a positive attitude and openness toward the ever changing social and cultural makeup of the workplace.
- Work effectively with men and women of different perspectives, abilities, disabilities, races, religions, ages, lifestyle preferences and social, ethnic and cultural backgrounds.
- Respectfully acknowledge people's differences and recognize these differences as important and valuable.
- Promote inclusiveness.
- Be culturally sensitive and appropriate.
- Respect and value diverse backgrounds and traditions. DOC is an equal opportunity employer and does not discriminate on the basis of race, creed, color, national origin, sex, marital status, sexual orientation, gender identity diversity, age, honorably discharged veteran, veteran status, genetic information, or the presence of any sensory, mental or physical disability or the use of a trained guide dog or service animal by a person with a disability.
For questions about this recruitment, or to request reasonable accommodation in the application process, please email firstname.lastname@example.org or call us at (360) 725-8557. For TTY service, please call the Washington Relay Service at 7-1-1 or 1-800-833-6388.
Job Type: Full Time - Permanent
Job Number: 2016-10262
Department: Dept. of Corrections
Agency: State of Washington
Address: View Job Posting for Agency Information View Job Posting for Location, Washington, 98504.
Salary: $2,925.00 - $3,807.00 Monthly
Location: Thurston County – Tumwater, WA