Medical Assistance Specialist 3 (MAS3/AHEA)

Medical Assistance Specialist 3 (MAS3/AHEA) 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 Eligibility and Access (AHEA) 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 Eligibility and Access (AHEA) 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 State’s 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, Children’s 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:

• Bachelor’s 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: Demonstrated ability to:

• Solve problems independently while providing quality customer service.
• Use multiple software programs at the same time to complete tasks.
• Navigate complex defined procedures.
• Complete complex tasks both efficiently and accurately.

Experience:

• Performing conflict resolution with customers.
• Utilizing Microsoft Office programs such as Outlook, Word, and SharePoint.

Knowledge of Medicaid programs and eligibility. 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 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 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 HCA's 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 HCA’s 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 [email protected]. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Jake Nelko at 360-725-0945 or [email protected]. 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.

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