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MEDICAL CARE PROGRAM ASSOCIATE I

Recruitment #17-004394-0015

Introduction

**This position is limited to Maryland Department of Health- Office of Systems, Operations, and Pharmacy employees only.**

GRADE

10

LOCATION OF POSITION

MDH, Office of Systems, Operations and Pharmacy, Baltimore, MD

Main Purpose of Job

The main purpose of this position is to process Medicaid claims in the Claims Processing Unit. The Claims Specialist/Processor is responsible for the accurate and timely front end adjunction of medical claims for fee for service inpatient, outpatient facility and professional services. Normal processing includes data entry of the claim, the review and interpretation benefits and edit/audit resolution, claim payment and routing claims for review to OHS for resolution. The employee will follow state and federal regulations when determining responsible payer, coding of all claims and ensuring that clean claims are filed to each payer. This position had many changing processing procedures, provider/recipient eligibility determination and system modifications.

MINIMUM QUALIFICATIONS

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

Experience: One year 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. Thirty credit hours from an accredited college or university may be substituted for the required experience.

LIMITATIONS ON SELECTION

**This position is limited to Maryland Department of Health- Office of Systems, Operations, and Pharmacy employees only.**

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.  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. Candidates may remain on the certified eligible list for a period of at least one year.

Online applications are highly recommended. However, if you are unable to apply online, the paper application may be submitted to MDH, 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 additional information is required, the preferred method is to upload.  If unable to upload, please fax requested information only to 410-333-5689.  Only additional materials that are required will be accepted for this recruitment. All additional information must be received by the closing date and time.

Resumes will not be accepted in lieu of a completed application.

For questions regarding this recruitment, please contact the MDH Recruitment and Selection Division at 410-767-1251. 

If you are having difficulty with your user account or have general questions about the online application system, please contact the MD Department of Budget and Management, Recruitment and Examination Division at 410-767-4850 or Application.Help@maryland.gov

Appropriate accommodations for individuals with disabilities are available upon request by calling: 410-767-1251 or MD TTY Relay Service 1-800-735-2258.

BARGAINING UNIT STATUS

The incumbent in this position is a member of a covered bargaining unit and will be required to pay a bi-weekly service fee to the exclusive representative of the bargaining unit.

BENEFITS

FURTHER INSTRUCTIONS

As an equal opportunity employer, Maryland is committed to recruiting, retaining and promoting employees who are reflective of the State’s diversity. People with disabilities and bilingual candidates are encouraged to apply. We thank our Veterans for their service to our country.

The resulting certified eligible list for this recruitment may be used for similar positions in this or other State agencies.




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