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MEDICAL CARE PROGRAM ASSOCIATE LEAD/ADVANCED

Recruitment #21-004434-0008

GRADE

ASTD12

LOCATION OF POSITION

MDH, Office of Systems, Operations & Pharmacy, 201 W. Preston Street, Baltimore, MD

Main Purpose of Job

The main purpose of this position will be to provide support services to supervisory/management and lower level staff in the Medical Assistance Provider Relations Unit (CMS-1500 Billing/Call Center) in the Provider Resolution Division within the Medicaid Provider Services Administration. This position will also (a) provide support by overseeing the day to day work of lower level MCPA’s (b) assist w/training current and new MCPA, (c) assign, approve and review work of lower level staff, (d) independently process correspondence, reports, documents, and collation of information to and from various sources internally and externally to resolve complex inquiries via phone, email, fax or written correspondence. This position will respond to requests from internal and external inquiries; process information, and other documents by using knowledge of the State and Federal policies and procedures. This position will also interpret and process program specific information, policies, regulations and guidelines in a variety of program related activities as it relates to the CMS1500 billing process. This position will function within a Call Center environment and will serve as a primary information resource for the provider community and its fiscal representatives that make inquiries and register complaints regarding policy and procedures effecting payment of claims. This position will be responsible for applying and interpreting Medical Assistance regulations and policies regarding fee for service inpatient and outpatient services covered by the Program. This position will need to exercise a significant degree of independence of action and decision-making with the ability to communicate with various MDH units and vendors. This position will also assist with monitoring staff for adherence to all service level requirements applicable to claims processing as well as other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

MINIMUM QUALIFICATIONS

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

Experience: Three 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 Medicaid experience with the Medicaid systems and fee for service claims processing.

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 that 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 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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