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MEDICAL CARE PROGRAM ASSOCIATE II

Recruitment #21-004395-0007

GRADE

ASTD11

LOCATION OF POSITION

MDH/Prevention and Health Promotion Administration, Baltimore, Maryland

Main Purpose of Job

This position will perform various tasks and duties in the Medicaid division of the Maryland Department of Health (MDH)'s Prevention and Health Promotion Administration (PHPA)'s Office of Systems, Operations and Pharmacy (OSOP). This position will be responsible for determining eligibility, as well as for processing various types of claims, including batch claims and both paper and electronic claims. In regards to claims, this position will also reconcile any errors related to claims, in addition to resolving both provider issues and all claims related to the functions of a pharmacy, physician and/or hospital.

Furthermore, this position will process and mail KDP premium invoices; update the KDP Eligibility file by utilizing data on the HMS TPL resource file; and, respond to inquiries from applicants, recipients, pharmacies, providers, advocates, and others, in order to provide information and resolve any complaints and outstanding issues. Finally, this position will complete any clerical duties associated with the functions listed above, and will be expected to provide any clerical support, as requested.

MINIMUM QUALIFICATIONS

Education: Graduation from an accredited high school or possession of a high school equivalency certificate.

Experience: Two years of clerical experience applying policies in a medical care, health insurance, or federal or State entitlement program.

Notes: 1. Additional general clerical experience may be substituted, on a year-for-year basis, for the required education.

2. College credits from an accredited college or university may be substituted for the required experience, at the rate of 30 credit hours for one year of experience.

DESIRED OR PREFERRED QUALIFICATIONS

The desired candidate should have experience determining one's eligibility for services in a health-related field. He/she should also have experience using online data management systems, including CARES, BEACON, SVES, and MMIS.

SELECTION PROCESS

Applicants who meet the minimum (and selective) qualifications will be included in further evaluation. The evaluation may be a rating of your application, based on your education, training and experience, as they relate to the requirements of the position. Therefore, it is essential that you provide complete and accurate information on your application. 

Please report all related education, experience, dates, and hours of work. Clearly indicate your college degree and major on your application, if applicable. For education obtained outside the U.S., any job offer will be contingent on the candidate providing an evaluation for equivalency by a foreign credential evaluation service prior to starting employment (and may be requested prior to interview). 

Complete applications must be submitted by the closing date. Information submitted after this date will not be added. 

Incorrect application forms will not be accepted. Resumes will not be accepted in lieu of a completed application.

Candidates may remain on the certified eligible list for a period of at least one year. The resulting certified eligible list for this recruitment may be used for similar positions in this, or other, State agencies.

BENEFITS

FURTHER INSTRUCTIONS

Online applications are highly recommended. However, if you are unable to apply online, the paper application (and supplemental questionnaire) may be submitted to MDH, Recruitment and Selection Division, 201 W. Preston St., Room 114-B, Baltimore, MD 21201. Paper application materials must be received by 5 pm, close of business, on the closing date for the recruitment, no postmarks will be accepted.

If additional information is required, the preferred method is to upload. If you are unable to upload, please fax the requested information to, 410-333-5689. Only additional materials which are required will be accepted for this recruitment. All additional information must be received by the closing date and time.

For questions regarding this recruitment, please contact the MDH Recruitment and Selection Division, at 410-767-1251.

If you are having difficulty with your user account or have general questions about the online application system, please contact the MD Department of Budget and Management, Recruitment and Examination Division, at 410-767-4850 or Application.Help@maryland.gov

Appropriate accommodations for individuals with disabilities are available upon request by calling: 410-767-1251 or MD TTY Relay Service, at 1-800-735-2258.

We thank our Veterans for their service to our country.

People with disabilities and bilingual candidates are encouraged to apply.

As an equal opportunity employer, Maryland is committed to recruitment, retaining and promoting employees who are reflective of the State's diversity.




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