[Hiring] Medical Assistance Specialist 4 @State of Washington

Role Description

This is a full-time permanent, remote position. Employees may occasionally be asked to attend an in-person meeting or event based on business needs. This is an internal opportunity and is only open to current HCA employees. All HCA employees are required to be Washington state residents upon their first day of employment.

Lead a team of medical assistance specialist 3s in the dental authorization unit, including:

• Training staff
• Performing quality control
• Updating policies and manuals
• Helping staff with complex situations
• Backing up the team’s supervisor when needed

Key Responsibilities

• Independently train and lead staff in determining client eligibility.
• Ensure accuracy and the smooth and timely response to requests by MAS3's.
• Review claims in relation to claim rejection and analyze problems.
• Advise providers and generate client notification of decision outcomes.
• Respond to complex staff questions and research to find answers.
• Answer internal and external e-mails and phone calls from supervisors, systems staff, unit staff, and other departments.
• Develop training materials for staff in Excel, PowerPoint, and Word.
• Train new staff and existing staff on upcoming initiatives and system changes.
• Lead MAS meetings to go over process changes and general questions from staff.
• Periodically silent monitor staff calls for quality customer service and follow up with staff on training needs.
• Participate in continual process improvement endeavors and revise prior authorization processes and procedures, database modifications/maintenance, and forms development.

Qualifications

• Advanced knowledge of program policies to communicate them with providers.
• Demonstrated proficiency in customer service across your career.
• Ability to work well with colleagues on various levels of an organization.

Requirements

• Competency in participating in continuous process improvement endeavors.
• Skill in consulting with Unit Supervisors and Operations Managers regarding policy updates.
• Ability to clarify intricate program policies and provider billing instructions.
• Providing high-level consultative services over toll-free lines.
• Ability to independently train and onboard new staff.
• Competency in developing comprehensive training materials utilizing MS Office tools.
• Capability to conduct silent call monitoring to ensure high-quality customer service.
• Skill in keeping the team focused and supporting peers.
• Ability to ensure accuracy and timely responses to requests.
• Ability to handle internal team issues and complex customer complaints.
• Extensive knowledge of the Washington Administrative Code (WAC) guidelines.
• Advanced proficiency in reviewing and researching complex procedure codes.
• Ability to review and analyze complex billings, claim rejections, and denials.
• Expertise in verifying client eligibility within the Dental-Related Services package.
• Technical capability to build authorization screens and track workload inventory.
• Responsibility for maintaining and navigating the internal Dental SharePoint repository.
• Advanced daily utilization of MS Office tools.
• Competency in generating legally compliant client/provider decision outcome notifications.
• Skill in working harmoniously with other divisions and external departments.

Preferred Qualifications

• Bachelor’s degree AND two years of experience in a dental office setting.
• Associate degree AND four years of experience as described above.
• Six years of experience as described above.
• One year as a Medical Assistance Specialist 3.

Benefits

• Remote work and flexible schedules.
• Medical, dental, vision, and basic life insurance.
• Paid vacation, sick leave, and 12 paid holidays.
• Paid Family and Medical Leave (PFML).
• Retirement options to plan for the future.
• Training and professional development opportunities.
• Employee wellness programs.

Application Directions

To be considered, you must complete the online application in full and submit all required materials. Incomplete applications or applications missing required materials will not be considered. When completing your application, please include the following required materials:

• Cover letter describing your qualifications for this specific position.
• Resume detailing your applicable experience and education.
• Three (3) professional references.