Technician program

THE POSITION

Are you looking for meaningful work supporting programs with a positive impact on the lives of others? The Bureau of Data and Claims Management, Division of Managed Care Systems Support is seeking a Medical Assistance Program Technician to oversee the programs administered by the Office of Medical Assistance.

These responsibilities will include the compilation, distribution, and tracking of data or requests required for the development of rates and monitoring reimbursement methods for capitation, maternity care, and special incentive payments, as well as the management of membership in Managed Care Plans (MCOs).

If you enjoy working as part of a productive team to accomplish goals and tasks, this is the job for you!

DESCRIPTION OF WORK

• In this position, you will receive electronic requests from Managed Care Organizations (MCOs); County Assistance Offices (CAOs);
• Enrollment Assistance Contractor (EAC); Health Insurance Premium Payment (HIPP); Living Independence for the Elderly (LIFE);

Children, Youth and Families (CYF); and the Bureau of Managed Care Operations (BMCO) to enroll or disenroll recipients from managed care or to correct coverage due to stipulations within the plan agreements for the HealthChoices state-wide managed care programs.

You will apply changes to the Client Information System (CIS) relating to managed care coverage and notify the CAO of any changes needed to correct Medical Assistance (MA) eligibility or to add facility or waiver code information.

You will process claim adjustments and / or initiate capitation payments to PROMISe when necessary. An ideal candidate for the position will possess knowledge of the HealthChoices contract and have a general knowledge of CIS.

In addition, you will provide technical support related to maternity care payment process and receive requests to enroll newborns.

You will be required to perform thorough research in order to process and complete actions necessary in different programs.

You will be responsible for reviewing and evaluating incoming information to process claims, as well as determining eligibility of recipients for enrollment or disenrollment.

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 : 30 PM, Monday - Friday, with 60-minute lunch.
• Telework : You may have the opportunity to work from home (telework) part-time, with a minimum of one day per month in the office.

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.

• 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.

REQUIRED EXPERIENCE, TRAINING & ELIGIBILITY

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.
• 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.

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.employment.pa.gov / Additional Info / Pages / default.

aspx and click the Veterans' Preference tab or contact us at ra-cs-vetpreference@pa.gov.

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.

EXAMINATION INFORMATION

• 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.

Learn more about our Total Rewards by watching this short video!

Health & Wellness

We offer multiple health plans so our employees can choose what works best for themselves and their families. Our comprehensive benefits package includes health coverage, vision, dental, and wellness programs.*

Compensation & Financial Planning

We invest in our employees by providing competitive wages and encouraging financial wellness by offering multiple ways to save money and ensure peace of mind including multiple retirement and investment plan options.

Work / Life Balance

We know there's more to life than just work! Our generous paid leave benefits include paid vacation, paid sick leave, eight weeks of paid parental leave, military leave, and paid time off for most major U.

S. holidays, as well as flexible work schedules and work-from-home opportunities.*

Values and Culture

We believe in the work we do and provide continual opportunities for our employees to grow and contribute to the greater good.

As one of the largest employers in the state, we provide opportunities for internal mobility, professional development, and the opportunity to give back by participating in workplace charitable giving.

Employee Perks

Sometimes, it is the little "extras" that make a big difference. Our employees receive special employee-only discounts and rates on a variety of services and memberships.

For more information on all of these Total Rewards benefits, please visit www.employment.pa.gov and click on the benefits box.

Eligibility rules apply.

How many years of full-time 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 do you possess?

• 3 years or more
• 2 but less than 3 years
• 1 but less than 2 years
• Less than 1 year
• None

If you are claiming experience in the above question, please list the employer(s) where you gained this experience in the text box below.

The employer(s) and a description of the experience must also be included in the appropriate sections of your application if you would like the experience to be considered in the eligibility decision.

If you claimed you do not have experience, type N / A in the text box below.

Have you completed post-high school training in a health care services field?

If you are claiming credits / degree, you must upload a copy of your college transcript(s) for this education to be considered in the eligibility decision.

Unofficial transcripts are acceptable. You must attach your transcript(s) prior to the submission of your application by using the "Attachments" tab on the left.

You will not be able to add transcript(s) to the application after it has been submitted. If you answer "yes" to this question based on education acquired outside of the United States, you must also upload a copy of your foreign credential evaluation.

For more information on foreign education credentials, please visit https : / / www.employment.pa.gov / Additional Info / Pages / default.

aspx#q3 and click on Other Information.

If you are claiming post-high school training, please provide your responses to the two items listed below. If you answered no, please type N / A in the box below.

• Training Source
• Credits / Clock Hours

Have you completed college coursework in a health care services field?

If you are claiming credits / degree, you must upload a copy of your college transcript(s) for this education to be considered in the eligibility decision.

Unofficial transcripts are acceptable. You must attach your transcript(s) prior to the submission of your application by using the "Attachments" tab on the left.

You will not be able to add transcript(s) to the application after it has been submitted.

If you answer "yes" to this question based on education acquired outside of the United States, you must also upload a copy of your foreign credential evaluation.

For more information on foreign education credentials, please visit https : / / www.employment.pa.gov / Additional Info / Pages / default.

aspx#q3 and click on Other Information.

You must complete the supplemental questions below. These supplemental questions are the exam and will be scored. They are designed to give you the opportunity to relate your experience and training background to the major activities (Work Behaviors) performed in this position.

Failure to provide complete and accurate information may delay the processing of your application or result in a lower-than-deserved score or disqualification.

You must complete the application and answer the supplemental questions. Resumes, cover letters, and similar documents will not be reviewed for the purposes of determining your eligibility for the position or to determine your score.

All information you provide on your application and supplemental questions is subject to verification. Any misrepresentation, falsification or omission of material facts is subject to penalty.

If requested, you must provide documentation, including names, addresses, and telephone numbers of individuals who can verify the validity of the information you provide in the application and supplemental questions.

Read each question carefully. Determine and select which "Level of Performance" most closely represents your highest level of experience / training.

List the employer(s) / training source(s) from your Work or Education sections of the application where you gained this experience / training.

The "Level of Performance" you choose must be clearly supported within the description of the experience and training information entered in your application or your score may be lowered.

In order to receive credit for experience, you must have worked in a job for at least six months in which the experience claimed was a major function.

If you have read and understand these instructions, please click on the "Yes" button and proceed to the exam questions.

If you have general questions regarding the application and hiring process, please refer to our FAQ page.

WORK BEHAVIOR 1 - RESPOND TO CUSTOMER QUESTIONS AND CONCERNS

Respond promptly and professionally to incoming telephone calls to the call center and emails from individuals needing assistance regarding a variety of program issues or concerns, and to convey the application process and eligibility criteria based on various policies and procedures.

• A I have experience responding to individuals via telephone and other correspondence in a call center environment regarding health care related issues or concerns, or to convey a health care related process.
• B I have experience responding to individuals via telephone and other correspondence in a call center environment regarding customer service related issues or concerns, or to convey a process.
• C I have experience fielding phone calls and other correspondence (in an office setting, not a call center environment) regarding health care related issues or concerns, or to convey a health care related process.
• D I have experience fielding phone calls and other correspondence (in an office setting, not a call center environment) regarding customer service related issues or concerns, or to convey a process.
• F I have NO experience or training related to this work behavior.

In the text box below, please describe your experience as it relates to the level of performance you claimed in this work behavior.

Please be sure your response addresses the items listed below which relate to your claim. If you indicated you have no work experience related to this work behavior, type N / A in the box below.

• The name of the employer(s) where you gained this experience
• The working environment (call center, office, etc.)
• Topic of discussion (health care related, customer service, etc.)
• Method of communication (telephone, email, written, etc.)
• Your specific duties and responsibilities

If you have selected the level of performance pertaining to the college coursework, please provide the requested information in the text box below.

Please be sure your response addresses the items listed below. If you indicated you have no training related to this work behavior, type N / A in the box below.

• College / University
• Course Title
• Credits / Clock Hours

WORK BEHAVIOR 2 - REVIEW AND VERIFY DATA

Review eligibility determinations with customers by verifying citizenship, identity, financial, employment, and other required data in various computer systems in order to discuss the accuracy of the information, answer questions, and resolve issues with the determination.

• A I have experience reviewing and verifying data with customers to ensure the information is accurate, answering related questions, and resolving any issues.
• B I have experience reviewing and verifying data with customers to ensure the information is accurate and answering related questions.
• C I have experience reviewing and verifying data to ensure the information is accurate.
• D I have successfully completed college-level coursework related to data entry, or bookkeeping.
• E I have NO experience or training related to this work behavior.

In the text box below, please describe your experience as it relates to the level of performance you claimed in this work behavior.

Please be sure your response addresses the items listed below which relate to your claim. If you indicated you have no work experience related to this work behavior, type N / A in the box below.

• The name of the employer(s) where you gained this experience
• Your specific duties and responsibilities regarding the accuracy of information
• Your specific duties and responsibilities answering questions
• Your specific duties and responsibilities regarding resolving issues

If you have selected the level of performance pertaining to the college coursework, please provide the requested information in the text box below.

Please be sure your response addresses the items listed below. If you indicated you have no training related to this work behavior, type N / A in the box below.

• College / University
• Course Title
• Credits / Clock Hours

WORK BEHAVIOR 3 - REVIEW AND INTERPRET POLICIES AND GUIDELINES

Review and interpret policies and operating guidelines in order to explain income and eligibility requirements to customers or other interested parties.

A I have experience reviewing and interpreting policies or guidelines in order to explain them to an interested party (customer, client, consumer, etc.

outside of my company or organization.

B I have experience reviewing and interpreting policies or guidelines in order to explain them to an interested party (co-worker, trainee, etc.

within my company or organization.

• C I have successfully completed college-level coursework related to statistical analysis or prelaw.
• D I have NO experience or training related to this work behavior.

In the text box below, please describe your experience as it relates to the level of performance you claimed in this work behavior.

Please be sure your response addresses the items listed below which relate to your claim. If you indicated you have no work experience related to this work behavior, type N / A in the box below.

• The name of the employer(s) where you gained this experience
• The parties involved (customers, clients, co-workers, trainees, etc.)
• Party affiliation (from another company / organization, part of your company / organization, etc.)
• Your specific duties and responsibilities

If you have selected the level of performance pertaining to the college coursework, please provide the requested information in the text box below.

Please be sure your response addresses the items listed below. If you indicated you have no training related to this work behavior, type N / A in the box below.

• College / University
• Course Title
• Credits / Clock Hours

WORK BEHAVIOR 4 - CUSTOMER ISSUES AND COMPLAINTS

Gather pertinent information regarding unresolved issues and complaints from customers via calls and emails; forward onto supervisory staff in written format for further investigation;

and follow up with customers to provide them with the resolution or outcome as needed.

A I have experience gathering information regarding issues and complaints from customers via calls or emails; forwarding them onto supervisory staff for further investigation;

and following up with customers to provide them with the resolution or outcome.

• B I have experience gathering information regarding issues or complaints from customers via calls or emails, and forwarding them onto supervisory staff for further investigation.
• C I have experience following up with customers to provide them with the resolution or outcome.
• D I have successfully completed college-level coursework related to technical writing, report writing, or organizational communication.
• E I have NO experience or training related to this work behavior.

In the text box below, please describe your experience as it relates to the level of performance you claimed in this work behavior.

Please be sure your response addresses the items listed below which relate to your claim. If you indicated you have no work experience related to this work behavior, type N / A in the box below.

• The name of the employer(s) where you gained this experience
• Your specific duties and responsibilities related to gathering information from customers
• Your specific duties and responsibilities regarding issues and complaints (forward to supervisor, resolve yourself, etc.)
• Your specific duties and responsibilities for follow-up with customer

If you have selected the level of performance pertaining to the college coursework, please provide the requested information in the text box below.

Please be sure your response addresses the items listed below. If you indicated you have no training related to this work behavior, type N / A in the box below.

• College / University
• Course Title
• Credits / Clock Hours

Required Question

Agency Commonwealth of Pennsylvania

Address 613 North Street

Harrisburg, Pennsylvania, 17120

Website http : / / www.employment.pa.gov

Last updated : 2024-06-17