State of Maryland

A Financial Agent Operations Chief is the managerial level of work in 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 are responsible for the overall direction of collection activities in all field offices of the Reimbursement Division.  Employees in this classification are required to develop and implement new plans, techniques and procedures to improve daily operations in the collection of monies due the State.  Employees in this classification supervise Financial Agent Supervisors.

Employees in this classification receive general supervision from a higher-level administrator.

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 Operations Chief is differentiated from the Financial Agent Supervisor II in that the Financial Agent Operations Chief is responsible for the overall activities in all field offices of the Reimbursements Division while the Financial Agent Supervisor II has supervisory responsibility for lower-level Financial Agents and responsibility for the supervision of a large region of field offices.

Implements procedures for the collection and reimbursement of funds due the State from patients, their relatives or guardians or from political subdivisions;

Supervises the Financial Agent investigative staff of the reimbursement program;

Consults with patients in an effort to determine schedules of payments and to obtain the sums due the State;

Enforces the determined schedules of payments;

Determines the appropriate legal or administrative procedure to be used in recovering sums due;

Drafts and executes agreements with patients and their legal representatives providing for reimbursement;

Ensures that the State’s claim is paid or filed before settlement of a deceased patient’s estate;

Assists Financial Agent Supervisors with the more difficult and technically involved reimbursement cases;

Reviews recommendations of Financial Agents regarding ability of patients to pay support and maintenance;

Prepares cases and makes recommendations to the Office of the Attorney General on their disposition;

Conducts formal and informal hearings on rates and claims of hardship;

Interprets the State laws, rules and regulations relating to the Central Reimbursement Program;

Advises the regional and central office staffs on legislative amendments and departmental policies;

Interviews and hires personnel for the Division of Reimbursements;

Prepares and submits budget requests, special and annual reports related to the field reimbursement program;

Recommends rules and regulations for the reimbursement program, subject to approval of the Attorney General;

Consults with representatives of other agencies whose programs affect the reimbursement program;

May appear as a witness in court on behalf of the State;

May serve on the Appeal Board reviewing final appeals from rate determinations affecting the liability of individuals for reimbursements;

Performs other related duties.

Knowledge of procedures and operating practices of the Reimbursement Program of the Maryland Department of Health;

Knowledge of rules, regulations and State laws governing the program;

Knowledge of legal procedures and remedies for enforcing financial liability;

Knowledge of the investigating methods and procedures for billing and collecting debts and judgments and the accounting of monies collected;

Knowledge of training, supervisory and administrative practices;

Knowledge of financial reports and statements;

Knowledge of business administration and finance;

Ability to direct, plan and coordinate the total field reimbursement program of the Maryland Department of Health;

Ability to arrange and review schedules of payment;

Ability to explain and interpret the State laws, rules and regulations relating to the reimbursement of funds for the care and maintenance of patients;

Ability to supervise and direct a large staff of Financial Agents and supervisors;

Ability to deal effectively with public and private officials and personal representatives of patients;

Ability to analyze financial statements and investigation reports on individuals;

Ability to prepare and present clear and accurate reports;

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

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

Experience: Six years of experience in health care financing work or the life/health insurance fields in investigation and/or adjustment of claims. Two years of this experience must have involved the supervision of other workers performing health care financing work.

Note: Candidates may substitute additional non-supervisory 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.