Health Ombudsman

Baltimore, MD - USA

Monthly Salary: $ 62220 - 87661

Posted on: 23 hours ago

Vacancies: 1 Vacancy

Job Summary

Introduction

The Attorney General is the chief legal officer of the State of Maryland. The Office of the Attorney General (OAG) has the general charge supervision and direction of the States legal business acting as legal advisors and representatives of the major agencies various boards commissions officials and institutions of State Government. The OAG also protects the public by civil enforcement of antitrust civil rights consumer protection and securities laws and regulations and by the prosecution of organized crime Medicaid fraud environmental crimes insurance fraud state tax evasion and other statutorily assigned matters. As Marylands 47th Attorney General Anthony G. Brown leads the Office with a critical focus on equity justice and fairness.

GRADE

This position offers a salary range of $62220 - $87661 with potential for advancement up to $96790 based on qualifications equity and hiring guidelines. Initial salary offers are determined by qualifications experience and available budget and typically do not exceed $87661.

LOCATION OF POSITION

Office of the Attorney General

Consumer Protection Division

Health Education and Advocacy Unit

200 St. Paul Place

Baltimore Maryland 21202

Main Purpose of Job

The Consumer Protection Division Health Education and Advocacy Unit (HEAU) is seeking a dedicated and compassionate individual to join our team as an Ombudsman. HEAU plays a vital role in protecting and empowering Maryland consumers by:

Assisting individuals in resolving billing disputes with health care providers and insurers.

Helping consumers navigate health insurance coverage denials and appeals.

Educating the public about their healthcare rights and responsibilities.

Advocating fair and equitable access to healthcare services.

The Unit receives approximately 2000 consumer complaints 4500 hotline calls and 6000 emails each year reflecting the high volume and critical nature of our work. The team is comprised of: two attorneys case manager an administrative assistant and seven ombudsmen. We also work with a dedicated group of volunteers interns and law clerks who support our mission year-round. Join our team to help Marylanders resolve complex health care issues to ensure fair access to care for all.

POSITION DUTIES

Key Responsibilities:

Review and analyze denied insurance claims to determine the basis for denial.

Assist consumers in understanding their rights and appeal options.

Prepare and submit written appeals with supporting documentation.

Assist consumers with a range of healthcare-related concerns including billing disputes; financial assistance; and coverage issues.

Communicate with insurance companies healthcare providers and patients to gather necessary information.

Track all complaint and appeal statuses and ensure timely follow-up.

Maintain accurate records of all complaints and correspondence.

Stay current with healthcare regulations payer policies and appeal procedures.

Educate consumers on the appeals process and advocate on their behalf.

Respond to inquiries via the HEAU hotline.

Supervise and mentor volunteers and interns assisting with complaint resolution.

This role involves frequent interaction by phone and in writing with consumers providers and insurers. Its an opportunity to help people resolve real-world problems and protect Marylands most vulnerable residents from unfair and deceptive practices.

MINIMUM QUALIFICATIONS

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

Experience: Three years of administrative staff or professional work.

Notes:

1. Candidates may substitute 30 college credit hours from an accredited college or university for each year up to twoyears of the required experience.

2. Candidates may substitute the possession of a Bachelors degreefrom a college or universityfor the required experience.

3. Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer involving staff work that included the regular use of independent judgment and analysis in applying and interpreting complex administrative plans policies rules or regulations or analysis of operational programs or procedures with recommendations for improvement on a year-for-year basis for the requiredexperience.

DESIRED OR PREFERRED QUALIFICATIONS

The ideal candidate will possess:

Bachelors degree in healthcare administration public health social work health law or a related field or associates degree with relevant experience.

2 years of experience in health insurance medical billing claims processing or patient advocacy.

Familiarity with insurance denial codes appeal processes and payer-specific guidelines.

Experience working in a healthcare setting nonprofit or consumer advocacy organization.

Leading teams in supervisory roles.

LICENSES REGISTRATIONS AND CERTIFICATIONS

Employees in this classification may be assigned duties which require the operation of a motor vehicle. Employees assigned such duties will be required to possess a motor vehicle operators license valid in the State of Maryland.

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 and answer all supplemental questions. 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/incomplete application forms will not be accepted. Please include complete dates of service job title and job duties. Resumes will not be accepted in lieu of a completed application.

Successful candidates will be placed on the eligible list for at least one year. 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

STATE OF MARYLAND BENEFITS

The successful candidate will be eligible for subsidized health benefits (medical prescription dental and vision coverage) and life insurance; leave including annual (vacation) personal sick and paid parental leave; and will be eligible for participation in a contributory defined benefit pension plan in which they are vested after ten years. State employees are eligible to participate in two supplemental retirement plans: the 457 Deferred Compensation Plan and the 401(k) Savings and Investment Plan. The State also offers a free mass transit benefit for local bus and express bus services.

FURTHER INSTRUCTIONS

Online applications are STRONGLY preferred. Please upload a resume in addition to the on-line application. If the online application process is not available please send your paper application and supplemental questionnaire to or fax to . TTY Users: call via Maryland Relay.

If you have specific questions about recruitment email

The Office of the Attorney General is an equal opportunity employer that encourages all interested persons to apply regardless of race color religion or belief ancestry national origin age marital status sexual orientation gender identity and/or expression disability pregnancy family or parental status veteran status genetic information or any protected category prohibited by local State or federal laws.

IntroductionThe Attorney General is the chief legal officer of the State of Maryland. The Office of the Attorney General (OAG) has the general charge supervision and direction of the States legal business acting as legal advisors and representatives of the major agencies various boards commissions o...