The Montana Department of Public Health and Human Services (DPHHS) has an opportunity for a reliable and resourceful Medicaid Program Integrity Compliance Specialist.
Our mission at DPHHS is to improve and protect the health, well-being, and self-reliance of all Montanans throughout every stage of their life. By joining our team, you will have the opportunity to perform meaningful work in public service to our state and its residents. Whether you are joining the workforce or have several years of experience, DPHHS has the opportunity for you!
This position identifies and investigates potential provider fraud, abuse and waste of Montana Medicaid and Healthy Montana Kids (HMK) programs. Duties include reviewing provider billing practices, as well as computer and information systems to investigate medical claims data and compliance with state and federal laws; analyzing data; interviewing providers; determining overpayments or underpayments, etc.
What We Can Offer You
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 program. Visit the Health Care and Benefits Division for more information at https://benefits.mt.gov/. In addition to employee benefits, there are a wide range of advancement opportunities within the largest state agency in Montana.
What You Can Offer Us
- Knowledge of Medicaid rules, medical claims processing, medical terminology and coding principles and practices.
- Knowledge of reviewing, investigation, and research.
- Excellent written and verbal communication skills.
- Analytical and critical thinking skills.
- Ability to operate personal computer and general office equipment as necessary to complete essential functions, including using spreadsheets, word processing, database, email, internet, and other computer programs.
- Meet minimum qualifications: Bachelor’s degree in health sciences, health information, accounting, business, or social sciences related field. Two years’ experience with medical claims, medical coding, or medical review of services. Other combinations of related education and experience may be considered on a case-by-case basis. Preferred coding certification through American Health Information Management Association (AHIMA) or American Academy of Professional Coder (AAPC).
For a copy of the full job description or if you need a reasonable accommodation in the application or hiring process, contact Heidi Greenback at Heidi.firstname.lastname@example.org.
How to Apply
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 uploading correctly to the specific application for this position.
This position will be posted until filled with frequent screening of applications.