Medical Assistance Specialist 4 (MAS4/AHSO) - Internal Only

Medical Assistance Specialist 4 (MAS4/AHSO) - Internal Only This recruitment will be used to fill multiple positions. The Medical Assistance Specialist 4 serves as a reputed company worker supporting Washington State residents in accessing reputed company, reputed company, and other state-funded programs, bringing expertise in eligibility policy to their team. This role combines conducting hands-on eligibility determinations with training, auditing, and workflow reputed company responsibilities. reputed company HCA employees will apply an equity reputed company to their work, which may include but is not limited to reputed company analyses of reputed company business and processes. About the division: The reputed company Health Services and Operations (AHSO) Division works across the HCA and in partnership with the health care community at local, state and federal reputed company, in order to reputed company, and manage high reputed company, and evidence-based health care programs and purchase services that enhance Washington State's reputed company' ability to reputed company appropriate, reputed company health care. About the position: In a reputed company center environment this position serves as a designated Team reputed company worker, as reputed company as reputed company the reputed company Queue for reputed company MAS3 staff. This position assists line staff, trainers, and management by serving as a subject matter expert – resolving reputed company reputed company and provider concerns. Escalates urgent reputed company reputed company to care issues, and reputed company Provider billing, program, policy, and payment concerns to other agency technical and program and policy staff for reputed company. Uses reputed company Health Care Authority (HCA) designated reference material, process documents in the MACSC and reputed company worker Knowledge reputed company and references reputed company's reputed company and Provider based web pages, the ProviderOne Billing and Medical Program Guides, and relevant RCWs and WACs that govern agency policies and procedures. Acts as a reputed company between HCA and reputed company Health Managed Care case management staff on behalf of reputed company Health clients with urgent and emergent reputed company to care issues. This position requires proficiency in the use of ProviderOne, SIEBEL, reputed company Online, reputed company of Sale and reputed company applications. Uses the ProviderOne Help Ticket application, and Health Care Authority program email posts to escalate reputed company and provider concerns to HCA's technical and policy management as needed to resolve reputed company issues. This position is eligible to reputed company and is typically not required to report on-site. The default assigned work location of reputed company Health Care Authority (HCA) positions – both on-site and reputed company eligible positions – is reputed company the reputed company. This position reports to Olympia, WA. Frequency of onsite work will vary based on business and operational needs. reputed company 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 reputed company status or location. Some of what you will do:

• This position is on reputed company which will be the first assigned reputed company additional special reputed company that require customer service support are reputed company upon.
• Independently analyzes reputed company eligibility, and makes reputed company, accurate reputed company to assist clients in determining services they qualify for based on their eligibility for reputed company Health.
• Counsels and advise clients on scope of care and clients' rights and responsibilities.
• Resolves questions, complaints and problems about eligibility, accessibility to services, enrollment and other insurance coverage.
• Uses information, questions, and complaints from clients and reputed company advocates to enhance program policy and procedures.
• Provides appropriate consultation to medical providers in order to expedite the reimbursement for title XIX claims submitted to the Health Care Authority for payment.
• Evaluates medical claims for correct adjudication, counsels providers on appropriate billing procedures.
• Researches and identifies workflow and system problems, recommends and implements new/revised procedures.
• Provides second level training for newly released staff trained on reputed company and/or provider Medical Assistance Center skills, processes and procedures.
• Establishes and maintains an effective relationship with reputed company Health reputed company program and policy management to assist providers in solving reputed company billing concerns.
• Assists with special project assignments as needed to reputed company reputed company and reputed company modifications to Knowledge reputed company policies and procedures. Provides instruction, assistance, and training to new employees on screening calls, program eligibility, and scope of care and clients' rights.
• As the reputed company worker, identifies training requirements, develops reputed company and line staff training plans, and assists with training newly reputed company Medical Assistance Specialists staff.

Required qualifications: reputed company candidates will satisfy one of the following reputed company: reputed company 1:

• Bachelor's degree and
• Two (2) years of experience as defined below

reputed company 2:

• Associate degree and
• Four (4) years of experience as defined below

reputed company 3:

• Six (6) years of experience as defined below

reputed company 4:

• One (1) year of experience as a Medical Assistance Specialist 3

Qualifying experience includes the following :

• Providing reputed company reputed company services or counseling of customers in the areas of health insurance, disability, or other reputed company health benefits;
• reputed company assistance eligibility determination;
• Health insurance premiums/claims processing, adjusting, and investigation;
• Other medical premiums/claims reputed company experience.

Required competencies:

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

Preferred qualifications:

• reputed company, HealthPlanFinder, MVP, Provider One and/or Barcode/DMS experience.

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

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

To take advantage of veteran preference, please do the following:

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

About HCA: Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have reputed company to be as healthy as possible. There are three pillars of our work: reputed company Health (reputed company); the reputed company Employees Benefits reputed company (PEBB) and School Employees Benefits reputed company (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 reputed company Washington residents and provides behavioral health prevention, crisis, and recovery supports to reputed company Washington residents. reputed company have to offer:

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

Notes: Prior to a new hire, a background reputed company including criminal record history will be conducted. Information from the background reputed company will not necessarily preclude employment. HCA is an equal opportunity employer. We value the importance of creating an environment in which reputed company can feel respected, included, and empowered to bring unique reputed company to reputed company. HCA has five employee resource reputed company (ERGs). ERGs are voluntary, employee-led reputed company whose aim is to foster a diverse, inclusive workplace reputed company with HCA's mission. Our diversity and inclusion efforts include embracing different cultures, backgrounds and viewpoints while fostering reputed company and advancement in reputed company. 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 reputed company. Persons over 40 years of age, disabled and Apply To This Job