Medical Assistance Program Technician

Are you interested in technical and administrative work that helps state medical assistance program services run fairly and effectively? Apply for this Medical Assistance Program Technician role with the Bureau of Program Integrity, Division of Third Party Liability, Recovery Section, Statement of Claim Creation Unit. With us, you will review, analyze, and compute medical, cash, personal injury, and estate claims in which the Commonwealth seeks recovery, ensuring work is accurate, consistent, and uses the correct standards. Take the next step in your career as part of a team that works to protect public resources, strengthen financial accountability, and support community wellbeing!

This position focuses on decoding, analyzing, calculating, and summarizing information in medical claims. Work supports accurate and timely creation and processing for statement of claims across various medical and financial situations. As a Medical Assistance Program Technician, you will perform the following duties:

• Claim Analysis: Independently review complex medical claims to determine which relate to specific personal injury or decedent estate cases
• Information Gathering: Contact facilities and agencies as well as analyze correspondence and forms to obtain required details
• Computations: Calculate and update medical and cash payment amounts by determining the amount of cash received using the correct standards permitted by federal law
• Data Explanations: Review and interpret complex client encounter data from managed care organizations to explain the fiscal processes determining the amount due and owed
• Adjustment Updates: Identify adjustments made to claims to create and update statement of claims
• Regulation Knowledge: Apply federal and state regulations and policies to independently identify and follow proper procedures.

Interested in learning more? Additional details regarding this position can be found in the position description.

Work Schedule and Additional Information:

• Full-time employment
• Work hours are 8:00 AM to 4:00 PM, Monday - Friday, with a 30-minute lunch.
• Free parking.
• Telework: You may have the opportunity to work from home (telework) part-time, up to three days per week. In order to telework, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. If you are unable to telework, you will have the option to report to the headquarters office in Harrisburg. The ability to telework is subject to change at any time. Additional details may be provided during the interview.
• Salary: In some cases, the starting salary may be non-negotiable.
• You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.

QUALIFICATIONS

Minimum Experience and Training Requirements:

• Three years of para-technical experience which involved reviewing and responding to inquiries relating to applicable services or benefits in health care insurance programs, health care services, or medical assistance program services; or
• Any equivalent combination of experience and training.

Other Requirements:

• You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency Guidelines.
• You must be able to perform essential job functions.

How to Apply: 

• Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education).
• If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.
• Your application must be submitted by the posting closing date. Late applications and other required materials will not be accepted.
• Failure to comply with the above application requirements may eliminate you from consideration for this position. 
• All application materials and interview responses must reflect the applicant’s own experience, qualifications, and work. Applicants may use generative AI tools for preparation purposes only. Use of AI to misrepresent or falsify information, or to assist during interviews, is not permitted. Review the Guidance for Generative AI Tools & Job Seekers for additional information.

Veterans: 

• Pennsylvania law (51 Pa. C.S. §7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to www.pa.gov/agencies/employment/how-to-apply.html and click on Veterans.

Telecommunications Relay Service (TRS): 

• 711 (hearing and speech disabilities or other individuals).

If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.

The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.

• Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam).
• Your score is based on the detailed information you provide on your application and in response to the supplemental questions.
• Your score is valid for this specific posting only.
• You must provide complete and accurate information or:
  • your score may be lower than deserved.
  • you may be disqualified.
• You may only apply/test once for this posting.
• Your results will be provided via email.