Claims Examiner 2 (11722)
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- 25141497 Requisition #
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- 22 hours ago Post Date
To be considered for this position you must complete the state application and attach all required documents through the Montana State Careers site at www.statecareers.mt.gov
The Montana Department of Public Health and Human Services (DPHHS) has a career opportunity within the Health Resources Division.
This position is with the Health Resources Division. This position is a Medicaid Claims Specialist and provides technical support primarily in the areas of disputed or pending claims resolution, pricing of specialized procedures, and maintenance of data systems for claims adjudication. Based on paid claims information, designs, and produces reports on program utilization and expenditures. Researches and adjudicates paid, denied, or suspended Medicaid claims independently or in coordination with program staff. Determines correct course of action on disputed claims according to policy, administrative rules, agency and contractor records, industry manuals. Represents the Department in administrative Reviews and Fair Hearings related to the work of the position.
Why Join DPHHS
Our mission at DPHHS is serving Montanans in their communities to improve health, safety, well-being, and empower independence. By joining our department, you will have the opportunity to perform meaningful work in public service to our state and its residents.
The State of Montana's comprehensive benefits package includes healthcare coverage, retirement plans, paid vacation, sick leave, and holidays, work/life balance, and eligibility to participate in the Public Service Loan Forgiveness (PSLF) program. In addition, DPHHS is the largest state agency with a wide range of advancement opportunities whether you are joining the workforce or have several years of experience.
Qualifications for this Career Opportunity
- General knowledge of medical billing and coding terminology.
- Skill in verifying the accuracy of data.
- Ability to apply general rules to specific problems.
- Ability to plan, organize, gather information and conduct research.
- Meet minimum qualifications:
- Bachelor’s degree in accounting, business administration, finance, economics, or a closely related field.
- One year of experience in healthcare claims processing.
- Other combinations of related education and experience may be considered on a case-by-case basis.
- Bachelor’s degree in accounting, business administration, finance, economics, or a closely related field.
- Preferred
- Medical coding certification
- Medical coding certification
How to Apply
To be considered for a DPHHS position, submit the following required documents with your application on the State of Montana Careers website. When submitting the required documents, you must check the "relevant document" box to ensure your attachments are uploaded correctly to your application for this position.
- Cover Letter
- Resume
- References
Successful applicants will be subject to background checks relevant to the position and must pass reference checks before an offer will be extended. DPHHS is an equal opportunity employer. Women, minorities, and people with disabilities are encouraged to apply. For a copy of the full job description or if you need a reasonable accommodation in the application or hiring process, contact DPHHS Human Resources listed below.
Additional Information
This position may be eligible for partial telework within the state of Montana. Specific conditions will be provided by the supervisor and must adhere to state policy.
This position may be eligible for a statutory $1.00 an hour base pay increase pending the ratification of the union agreement.
This position is open until filled with frequent screening of applicants.
