MEDICAL CARE PROGRAM ASSOCIATE II

11

Department of Health and Mental Hygiene

Medical Care Programs

Office of Systems, Operations, and Pharmacy

201 W. Preston Street

Baltimore, MD  21201 

Main purpose of this position is to demonstrate the ability to work at a full performance level by adjusting previously paid claims for corrected payments. The daily activities involve researching, screening, reviewing, batching, processing and adjusting all claim types received by the Program. The job includes applying, interpreting and processing Program specific policies and regulations. This position works independently receiving supervision from a Medical Care Program Associate Lead, Medical Care Program Supervisor or Medical Care Program Manager.

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.

This position researches and processes adjustments for all Medicaid claim types.  The successful applicant must be able to respond to inquiries and complaints from health care providers, as well as be able to apply and interpret Program specific policies and regulations.  The applicant should have training in an office setting performing clerical work and experience in applying policies in a medical care or health insurance program with six months customer service experience and be able to conduct telephone inquiries within the Department, other governmental agencies and the health care providers in order to perform the fundamental job duties as required by this position.

None.

Applicants who meet the minimum qualifications will be evaluated. 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. For education obtained outside the U.S., a copy of the equivalent American education as determined by a foreign credential evaluation service must accompany the application. All information concerning your qualifications must be submitted by the closing date. We will not consider information submitted after this date. For Recorded Job Information Call: 410-767-6018.

CONTRACTUAL EMPLOYEE HEALTH BENEFITS

Online application process is STRONGLY preferred. If online process is not available, please send your paper application to: DHMH, Recruitment and Selection Division, 201 W. Preston St., Room 114-B, Baltimore, MD 21201. The paper application must be received by 5 pm, close of business, on the closing date for the recruitment, no postmarks will be accepted.

Incorrect application forms will not be accepted.

If you need to submit additional information, the preferred method is to upload. If unable to upload, please fax requested information only to 410-333-5689.

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, and encourage them to apply.

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