Medical Support Specialist

Medical Assistance Specialist 5 (MAS5/AHSO) – Non-Permanent – Internal OnlyThis is a project position funded through 9/30/2027. This opportunity is internal and available to current HCA employees only. The Medical Assistance Specialist 5 leads and supervises a team of call center customer service providers serving Apple Health (Medicaid) customers across the state. The ideal candidate will have demonstrated skills in leadership, communication, and adaptability. If you are motivated to lead a team providing critical customer service to Washingtonians, this may be the position for you.About the division: The Apple Health Services and Operations (AHSO) Division works across the Health Care Authority (HCA) and in partnership with the health care community at local, state and federal levels, in order to develop, and manage high quality, and evidence-based health care programs and purchase services that enhance Washington State's citizens' ability to access appropriate, quality health care.About the position: The Medical Assistance Specialist 5 (MAS5) Plans, organizes, reviews, and supervises the work of assigned Medical Assistance Specialists, trainees, and support staff. Hires, counsels, evaluates, disciplines, and trains staff. Plans, organizes and implements customer service activities and schedules including call center operation, provider inquiries and Managed Care enrollment. Monitors real time call performance data provided by Avaya Call Management System and makes decisions regarding staffing levels and task assignments. This position also includes the need to have the ability to supervise in a collective bargaining environment. Interprets Medical Assistance WAC and RCW, program policies and procedures, provides direct assistance and guidance to Medical Assistance Specialists on complex client and provider issues. Responsible for assisting the Section Manager in developing new policies and procedures for call center operations, Managed Care enrollment activities, provider inquiries, HIPAA compliance, and claim processing activities. Compose, edit, and formalize letters in response to client and provider written and verbal inquiries. Responds to inquiries, complaints, and requests for information from legislative staff, Governor's office, and other provider or client advocates and stakeholders. Represents Medical Assistance Customer Service Center and Division of Apple Health Services & Operations in meetings and by interacting with other HCA divisions and programs in planning and implementing program service improvements for MACSC customers, system enhancements, and provider billing policy.This position is eligible to telework and is typically not required to report on-site. The default assigned work location of all Health Care Authority (HCA) positions – both on-site and telework eligible positions – is within the State of Washington. This position reports to Olympia, WA. Frequency of onsite work will vary based on business and operational needs. All agency employees are required to report on-site in Olympia on their first and last days of employment to pick up and return state-issued equipment, regardless of telework status or location.DutiesSome of what you will do:Plans, organizes, reviews, and supervises the work of assigned Medical Assistance Specialists, lead workers, and support staff in a collective bargaining environment.Hires, counsels, evaluates, disciplines, and trains staff.Plans, organizes, and implements customer service activities and schedules including call center operation, provider inquiries and Managed Care enrollments.Monitors call traffic of a high-volume call center that assists providers and clients by responding to questions and resolving issues pertaining to access to care, billing, claims payment, eligibility, and enrollment in Managed Care plans.Monitors real time call performance data provided by Avaya Call Management System and makes decisions regarding staffing levels and task assignments.Analyzes data provided by automatic call distribution management reporting system to monitor Medical Assistance Specialists' workload and performance.Interprets Medical Assistance WAC and RCW as well as program policies, and procedures, providing direct assistance and guidance to Medical Assistance Specialists on complex client and provider issues.Assists the Section Manager and Operations Team in developing new policies and procedures for call center operations, Managed Care enrollment activities, provider inquiries, HIPAA compliance, and claim processing activities.Composes, edits, and formalizes letters in response to inquiries, complaints, and requests for information from legislative staff, Governor's office, and other provider or client advocates and stakeholders.QualificationsRequired qualifications:Qualifying candidates will satisfy one of the following criteria options:Bachelor's degree and four (4) years of required experience as defined belowAssociate degree and six (6) years of required experience as defined belowEight (8) years of required experience as defined belowOne (1) year as a Medical Assistance Specialist 4 (MAS4)Two (2) years as a Medical Assistance Specialist 3 (MAS3)Required experience for this position is defined as:providing direct client services or counseling of customers in the areas of health insurance, disability, or other related health benefits;public assistance eligibility determination;health insurance premiums/claims processing, adjusting, and investigation; orother medical premiums/claims related experience.Required competencies:The ability to take action to learn and grow.The ability to take action to meet the needs of others.Preferred qualifications:Experience working in a call center environment.Proficient in the use of ProviderOne and Siebel Soft Phone.How to apply: Only candidates who reflect the minimum qualifications on their NEOGOV profile will be considered. Failure to follow the application instructions below may lead to disqualification. To apply for this position, you will need to complete your profile which includes three professional references and attach in separate files:A cover letter that specifically addresses how you meet the qualifications for this positionCurrent resumeTo take advantage of veteran preference, please do the following:Attach a copy of your DD214 (Member 4 long-form copy), NGB 22, or USDVA signed verification of service letter.Please black out any PII (personally identifiable information) data such as social security numbers. Include your name as it appears on your application in careers.wa.gov.Supplemental InformationAbout the HCA: Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.Meaningful work with friendly co-workers who care about those we serve Voices of HCAA clear agency mission that drives our work and is person-centered HCA's Mission, Vision & ValuesA healthy work/life balance, including alternative/flexible schedules and mobile work options.A great total compensation and benefit package WA State Government BenefitsA safe, pleasant workplace in a convenient location with restaurants, and shopping nearby.And free parking!Notes: Prior to a new hire, a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment.HCA is an equal opportunity employer. We value the importance of creating an environment in which all employees can feel respected, included, and empowered to bring unique ideas to the agency. HCA has five employee resource groups (ERGs). ERGs are voluntary, employee-led groups whose aim is to foster a diverse, inclusive workplace aligned with HCA's mission. Our diversity and inclusion efforts include embracing different cultures, backgrounds and viewpoints while fostering growth and advancement in the workplace. Studies have shown women, racial and ethnic minorities, and persons of disability are less likely to apply for jobs unless they feel they meet every qualification as described in a job description. Persons over 40 years of age, disabled and Vietnam era veterans, as well as people of all sexual orientations and gender identities are also encouraged to apply. If you have any questions about the required qualifications or how your experience relates to them, please contact us at View email address on click.appcast.io