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Company Name : Commonwealth of PA
Location : Dauphin County, PA
Position : Claims Investigation Agent
Job Description : THE POSITION
The Division of Third Party Liability is seeking a highly motivated professional person to help with the recovery of medical assistance expenditures that were incorrectly or provisionally paid on behalf of public assistance recipients.
DESCRIPTION OF WORK
Assess collection of potential cash and medical assistance claims against third parties and recipients. This is accomplished by reviewing and analyzing referrals received from county assistance offices, medical providers, attorney, insurance carriers, probate estates, other Commonwealth agencies and automated information systems, in order to determine if DHS benefits were inappropriately granted and to identify the responsible obligor.
Investigate cash and medical assistance claims for personal injury and estate cases by employing independent judgment through verbal and written communications with attorneys, insurance adjustors, medical providers, police departments, recipients, other Commonwealth agencies and public inquires, in order to perfect the Department’s claim.
Develop and maintain a working knowledge of legal and regulatory aspects of cash and medical benefits by researching, analyzing and interpreting the Public Welfare Code, applicable Federal and State regulations and statutes, insurance laws and regulations and relevant probate codes. Claim overpayments include, but not limited to cash, personal injury claims, workers compensation, medical malpractice, probate estates and court ordered restitution.
Work in conjunction with other units within Third Party Liability and the Office of Inspector General, other Departmental agencies and County Probation Offices, to facilitate the efficient collection of claims.
Additional details regarding this position can be found in the position description.
Work Hours and Additional Information:
Full-time employment.
Work hours: 8:00am – 4:00pm; Monday – Friday; 30 minute lunch.
You will have the opportunity to work from home (telework), part-time up to 3 days a week. In order to telework, you must have a securely configured high-speed internet connection. If you are unable to telework, you will have the option to report to the headquarters office in Harrisburg.
You will receive further communication regarding this position via email. Please check your email, including spam folders, for these notices.
REQUIRED EXPERIENCE, TRAINING & ELIGIBILITY
Qualifications:
Minimum Experience and Training Requirements – Four years of investigative public contact experience requiring the review and presentation of records, correspondence and documents used in the prosecution of cases, approval of claims or credit, or collection of debts; OR a bachelor’s degree in Pre-law, Criminal Justice, Police Science, or a closely related field; OR an equivalent combination of experience and training.
Must meet PA residency requirement – For more information on ways to meet PA residency requirements, follow the link and click on Residency.
Do not submit resumes, cover letters, and similar documents. These documents will not be reviewed and the information contained therein will not be considered for the purposes of determining your eligibility for the position or to determine your score. 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.
Must be able to perform essential job functions.
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%20Info/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).
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 & WellnessWe 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, six 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.
This post is listed Under Pennsylvania jobs
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