Medical Assistance Specialist 3 (MAS3AHSO)

Medical Assistance Specialist 3 (MAS3/AHSO)

This recruitment will be used to fill multiple positions.

These positions determine individual and family eligibility for Washington State medical assistance programs. Within the Apple Health Services and Operations (AHSO) Division this position supports the Health Care Authority (HCA) mission to provide access to medical care for all eligible Washington citizens.

All HCA employees will apply an equity lens to their work which may include but is not limited to all analyses of core business and processes.

About the division:

The Apple Health Services and Operations (AHSO) Division works across the Health Care Authority (HCA) and in partnership with the health care community at local state and federal levels in order to develop and manage high quality and evidence-based health care programs and purchase services that enhance Washington States citizens ability to access appropriate quality health care.

About the position:

This position supports the HCA mission to provide access to medical care for all eligible Washington citizens. The position determines initial eligibility and/or ongoing individual and family medical eligibility for Medicaid Title XIX Childrens Health Insurance Program (CHIP) Title XXI program and other Medicaid and state funded medical assistance programs available in Washington State.

This position is eligible to telework and is typically not required to report on-site.The default assigned work location of all Health Care Authority (HCA) positions both on-site and telework eligible positions is within the State of Washington. This position reports to Olympia WA. Frequency of onsite work will vary based on business and operational needs. All agency employees are required to report on-site in Olympia on their first and last days of employment to pick up and return state-issued equipment regardless of telework status or location.

Some of what you will do:

• Independently determine initial and/or ongoing eligibility for Health Care Authority Medicaid Title XIX CHIP Title XXI and other Medicaid and state funded medical assistance programs administered by the MEDS office.
• Apply complex federal and state eligibility regulations published in WAC and RCW to specific household circumstances resulting in accurate eligibility decisions.
• Use and manage multiple interdependent electronic systems including Automated Client Eligibility System (ACES) HealthPlanFinder ProviderOne Audit Plus Microsoft Office SOLQ Document Management System (DMS) and Employment Security Department (ESD).
• Analyze research and resolve complex eligibility issues applying proper rules and procedures with a high degree of independence.
• Conduct interviews over the telephone in person and/or through written correspondence with clients providers and/or third parties to obtain information for required documentation and verification to support program eligibility.
• Establish effective working relationships with clients and their advocates and manage difficult interactions with tact and diplomacy.
• Work with individual Take Charge providers to answer inquiries and resolve issues related to eligibility for the Take Charge Family Planning program.
• Answer inquiries resolve questions update eligibility records and otherwise maintain and expand access to medical care for eligible Washington citizens.

Required qualifications:

Qualifying candidates will meet one of the following criteria options:

Option 1:

• Bachelors degree and
• One year of qualifying experience as defined below.

Option 2:

• Associate degree and
• Three years of qualifying experience as defined below.

Option 3:

• Completion of a Certificate of Medical Billing and Coding or closely related certificate program and
• Three years of qualifying experience as defined below.

Option 4:

• Five years of qualifying experience as defined below.

Option 5:

• One year as a Medical Assistance Specialist 2.

Qualifying experience for this position is defined as:

• Providing direct client services or counseling of customers in the areas of health insurance disability or other related health benefits;
• public assistance eligibility determination;
• health insurance premiums/claims processing adjusting and investigation;
• other medical premiums/claims/eligibility related experience; or
• experience researching and analyzing complex rules regulations or policies and utilizing research and analysis to make determinations solve problems or complete work while providing direct customer service either in person or on the telephone.

Required competencies:

• The ability to take action to learn and grow.
• The ability to take action to meet the needs of others.

Preferred qualifications:

• Experience performing conflict resolution with customers.
• Knowledge of Medicaid programs and eligibility.
• Experience utilizing Microsoft Office programs such as Outlook Word and SharePoint.

How to apply:

Only candidates who reflect the minimum qualifications on their NEOGOV profile will be considered. Failure to follow the application instructions below may lead to disqualification. To apply for this position you will need to complete your profile which includes three professional references and attach in separate files:

• A cover letter that specifically addresses how you meet the qualifications for this position
• Current resume

To take advantage of veteran preference please do the following:

• Attach a copy of your DD214 (Member 4 long-form copy) NGB 22 or USDVA signed verification of service letter.
• Please black out any PII (personally identifiable information) data such as social security numbers. Include your name as it appears on your application in .

About HCA:

Functioning as both the states largest health care purchaser and its behavioral health authority the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars HCA purchases health care including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention crisis and recovery supports to all Washington residents.

What we have to offer:

• Meaningful work with friendly co-workers who care about those we serve Voices of HCA
• A clear agency mission that drives our work and is person-centered HCAs Mission Vision & Values
• A healthy work/life balance including alternative/flexible schedules and mobile work options.
• A great total compensation and benefit package WA State Government Benefits
• A safe pleasant workplace in a convenient location with restaurants and shopping nearby.
• And free parking!

Notes:

This position is covered by the Washington Federation of State Employees (WFSE). Once the listed position(s) is(are) filled this recruitment announcement may also be used to fill additional position(s) for up to sixty (60) days.

Prior to a new hire a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment.

HCA is an equal opportunity employer. We value the importance of creating an environment in which all employees can feel respected included and empowered to bring unique ideas to the agency. HCA has five employee resource groups (ERGs). ERGs are voluntary employee-led groups whose aim is to foster a diverse inclusive workplace aligned with HCAs mission.Our diversity and inclusion efforts include embracing different cultures backgrounds and viewpoints while fostering growth and advancement in the workplace. Studies have shown women racial and ethnic minorities and persons of disability are less likely to apply for jobs unless they feel they meet every qualification as described in a job description. Persons over 40 years of age disabled and Vietnam era veterans as well as people of all sexual orientations and gender identities are also encouraged to apply. If you have any questions about the required qualifications or how your experience relates to them please contact us at . Persons with disabilities needing assistance in the application process or those needing this job announcement in an alternative format may contact Jake Nelko at or .

The Washington State Health Care Authority (HCA) is an E-Verify employer. All applicants with a legal right to work in the United States are encouraged to apply.

E-Verify is a registered trademark of the U.S. Department of Homeland Security.

Subscribe to our weekly newsletter to receive a list of new job postings at HCA.