Third Party Liability Program Investigator

Are you ready to make a career move using your proven investigative skills to recover medical assistance funds? The Department of Human Services (DHS), Division of Third Party Liability in the Bureau of Program Integrity is seeking a Third Party Liability Program Investigator. If helping to ensure the integrity of Commonwealth funds motivates you, then apply to join our top-notch team today!

As a Third Party Liability Program Investigator, you will recover medical assistance expenditures that were incorrectly paid on behalf of DHS recipients. You will assess collection of potential cash and medical assistance claims by reviewing and analyzing referrals. Additional duties will include reviewing payments received and resolving any discrepancies. This role requires working knowledge of legal and regulatory aspects of cash and medical benefits, claims documentation and computation processes, and pertinent electronic data systems. You will also negotiate settlements to facilitate the efficient collection of claims, testifying in court appearances, and maintain the integrity of case records.

Interested in learning more? Additional details regarding this position can be found in the position description.

Work Schedule and Additional Information:

• Full-time employment, 37.5 hours per week.
• Work hours are 8:00 AM to 4:00 PM, Monday - Friday, with a 30-minute lunch.
• Free parking!
• Telework: You may have the opportunity to work from home (telework) part-time 3 days per week, with 2 days per week 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.

QUALIFICATIONS

Minimum Experience and Training Requirements:

• Four years of experience in the investigation of Health Care and personal injury records, correspondence and documents used in establishing legal liability, or determining approval of health care and personal injury insurance claims; or
• One year of experience as a Third Party Liability Program Technician; or
• An 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:

Telecommunications Relay Service (TRS):

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.

• 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.