State of Maryland

A Financial Agent IV is the first supervisory level of work investigating and determining the ability of patients or their legally responsible relatives to pay for the care and treatment received from a Maryland Department of Health facility.  Employees in this classification oversee the work of a unit responsible for reimbursement work for one or more facilities.  Employees in this classification located in a hospital setting supervise a field office.  Employees in this classification that perform specialized assignments supervise cost recovery operations for specific, State-operated services (e.g., Kidney Disease Program).  Employees in this classification supervise lower-level Financial Agents and secretarial/clerical support staff.

Employees in this classification receive general supervision from a Financial Agent Supervisor or higher-level administrator.  Employees are assigned to hospitals or specialized units within the Division of Reimbursements.  The work may require extensive travel and public contact.  Employees may be required to conduct investigations at any location within the State.

Positions in this classification are evaluated by using the classification job evaluation methodology.  The use of this methodology involves comparing the assigned duties and responsibilities of a position to the job criteria found in the Nature of Work and Examples of Work sections of the class specification.

The Financial Agent IV is differentiated from the Financial Agent III in that the Financial Agent IV has supervisory responsibility for lower-level Financial Agents either in a field office or in a cost recovery operation for a specific State-operated service while the Financial Agent III performs the full range of duties and responsibilities under general supervision.  The Financial Agent IV is differentiated from the Financial Agent Supervisor I in that the Financial Agent Supervisor I has supervisory responsibility for lower-level Financial Agents and oversees a small or medium region of reimbursement offices in various facilities and centers of the Maryland Department of Health.

Supervises the day-to-day activities of the lower-level Financial Agents and clerical staff in a reimbursement field office or a specialized unit within the Division of Reimbursements;

Analyzes and approves rate recommendations submitted by lower-level Financial Agents;

Interviews relatives of patients at time of admission to secure information regarding the financial condition of the patient and/or legally responsible relatives;

Secures information from neighborhood sources, banks, friends, relatives, welfare agencies, commercial and retail stores and all other sources to accurately access the financial condition of the patient;

Analyzes the financial condition of patients and recommends rate of monthly payments to be established by the department based on the collected financial information and State regulations;

Interprets the laws and regulations of the collection program to legally responsible relatives and the general public;

Investigates financial status of estates of deceased patients and recommends to the Maryland Department of Health that portion which may fairly be required to reimburse the costs of care;

Testifies in court regarding the assessment of payment rates or financial resources of individuals;

Performs other related duties.

Knowledge of investigative methods and procedures for billing and collecting debts and judgements;

Knowledge of rules, regulations and State law governing the Reimbursements Program;

Knowledge of the benefits available to hospital patients from various sources, such as insurance companies, Department of Human Services, Federal Insurance Contributions Act, Veterans Administration, Civil Service annuities, pension plans for retirement with disability, and federal programs involved with patients in State hospitals;

Ability to direct and supervise lower-level Financial Agents and clerical personnel;

Ability to understand and interpret State and federal laws, rules and regulations;

Ability to collect financial information through personal interviews, observations, and investigations;

Ability to deal with families of patients and the general public in a tactful manner;

Ability to prepare clear and accurate reports;

Ability to prepare and interpret financial statements;

Ability to establish and maintain effective working relationships with representatives of such agencies as the Attorney General’s office, Department of Human Services, Social Security Administration and Veterans Administration.

Education:   A Bachelor’s degree from an accredited college or university.

Experience: Four years of experience in health care financing work or the life/health insurance fields in the investigation and/or adjustment of claims.

Note: Candidates may substitute additional experience, at the rate of one year for 30 credit hours, for up to 60 credit hours of the required education.

Class specifications are broad descriptions covering groups of positions used by various State departments and agencies. Position descriptions maintained by the using department or agency specifically address the essential job functions of each position.

This is a Skilled Service classification in the State Personnel Management System.  All positions in this classification are Skilled Service positions.  Some positions in Skilled Service classifications may be designated Special Appointment in accordance with the State Personnel and Pensions Article, Section 6-405, Annotated Code of Maryland.

This classification is not assigned to a bargaining unit as indicated by the designation of S (supervisor), M (manager), T (agency head), U (Board or Commission member), W (student), X (Used by agency or excluded by executive order),  or Z (confidential).  As provided by State Personnel and Pensions Article, Section 3-102, special appointment, temporary, contractual, supervisory, managerial and confidential employees are excluded from collective bargaining.  Additionally, certain executive branch agencies are exempt from collective bargaining and therefore, all positions in those agencies are excluded from collective bargaining.