Summary

This job involves helping people leaving prison get signed up for health insurance like Medicaid and Medicare before they are released, so they can continue their medical care in the community without interruption.

It also includes processing disability benefit applications and coordinating with various teams and systems to track and submit these requests.

A good fit would be someone detail-oriented with experience in healthcare administration or social services, who is good at communicating and solving problems in a team setting.

Key Requirements

Experience processing and verifying applications for Medicaid, Medicare, and DSHS Disability benefits
Ability to independently determine eligibility for health coverage programs
Proficiency in coordinating with internal and external systems, including Provider One, OMNI, SharePoint, Health Plan Finder, and Washington Connection
Skills in tracking, updating, and auditing application statuses and reports
Experience running reports, self-auditing, and submitting claims for billable services
Strong communication and coordination with facility staff, external stakeholders, and teams
Proactive problem-solving and participation in team meetings to maintain positive dynamics

Full Job Description

Medical Assistance Specialist 3 (Project)

Department of Corrections

Tumwater, WA

Monthly Salary Range: $3,925 to $5,271

Washington State Department of Corrections is looking for a motivated Medical Assistance specialist 3 to join our team.

Medical Assistance Specialist 3 supports DOC's mission to improve public safety by reducing the barriers of continuity of healthcare by pre-enrolling releasing individuals in Medicaid and Medicare before their release from DOC Correctional Facilities to the community.

Communication necessary to complete applications includes collaboration with facility staff prior to release and community staff after release.

Additionally, the position processes applications for DSHS Disability benefits.

This role is crucial to ensure patients maintain their wellness as they transition to the community and access necessary healthcare.

Application assessment will be ongoing, and the hiring authority reserves the right to offer the position at any time during the recruitment process. It is to the applicant's advantage to apply as early as possible.

"This recruitment could be used to fill multiple permanent or non-permanent positions."

Requirements

Processes, updates, verifies, tracks and submits applications for Medicaid and DSHS Disability benefits for pre-enrollment for incarcerated individuals and those released/releasing from DOC Correctional Facilities as well as for inpatient covered services for our incarcerated population to include planned inpatient services, emergent inpatient events, gender affirming care inpatient procedures and alien emergency medical.

Independently determine if the individual may qualify for Medicaid/Medicare coverage.
Process, update, and verify information provided by individuals for pre-enrollment in Medicaid by coordinating multiple internal and external information systems and online portals such as Provider One and in coordination with facility staff and external stakeholders.
Update, track, and verify the status of an application throughout the pre-enrollment/enrollment process in OMNI, SharePoint databases and e-mail correspondence.
Coordinate with facilities for receipt of accurate and complete applications.
Enter OMNI-HS Encounters per protocols.
Update Scorecard per protocol.
Track completed applications daily.
Submit applications via online portals; Health Plan Finder and/or Washington Connection, for pre-enrollment for individuals with inpatient hospital stays, upcoming procedures requiring Medicaid prior authorization and those releasing from WA DOC Correctional Facilities.
Submit DSHS applications per protocol.
Self-auditing and working on reports to ensure all eligible patients receive an application.

Coordination with HCA’s Third-Party Administrator (TPA) for Medicaid Transformation Project billable services under Apple Health’s Reentry Initiative

Running reports from OMNI or EHR for billable services provided to patients in the covered pre-release period.
Review and auditing of OMNI reports for billable services.
Submitting reports to TPA that will submit claims for payment on DOC’s behalf.
Tracking outstanding claims in Provider One or TPA’s system.

Team Engagement

Proactive in identifying potential barriers and actively seeking solutions.
Participates in Team Meetings and contributes to positive team dynamic.
Keep calendar up to date with schedule and regularly communicate with team.

Other Duties

Participate in Health Services related projects and quality assurance as needed.
Assist with Violator RAB tracking, data entry and related processes/protocols.
Process incoming mail for the unit and adhere to current mail policy/procedure standards.
Work with facilities to ensure Medicaid mail correspondence sent to HQ is forwarded to facilities to give to the patients per 1115 waiver requirements.

Qualifications

Required qualifications:

One year experience as a Medical Assistance Specialist 1 OR equivalent
Experience providing direct client services or counseling of customers in the areas of health insurance, disability, or other related health benefits; public assistance eligibility determination; staff support for medical assistance; health insurance premium/claims processing, adjusting, and investigation; or other medical premiums/claims related experience will substitute year for year, for the required experience.

Preferred/Desired Qualifications:

Ability to multitask.
Exceptional time management skills.
Familiar with OMNI

Additional Information

Mission: The mission of DOC is to improve public safety by positively changing lives.

Our Vision: Working together for safer communities.

Our Commitment: To operate a safe and humane corrections system and partner with others to transform lives for a better Washington.

Our Core Values:

Cultivate an environment of integrity and trust: Corrections values partnership and trust. We foster openness and support courageous conversations. We are committed to doing what we say we are going to do by being accountable and taking personal ownership in our actions.

Respectful and inclusive interactions: Corrections appreciate and values individuals by promoting an inclusive and diverse environment, which encourages safety.

We respect, value, and listen to the thoughts, feelings, and perspectives of our stakeholders and consider the impact on those we serve as well as each other.

People's safety: Corrections believe in creating an environment that values physical, mental, and emotional security and well-being. We honor those who advance safety for all.
Positivity in words and actions: At Corrections, we assume positive intentions and believe there is a shared desire for the best outcome. We consistently demonstrate positive behavior and always put forth our best effort.
Supporting people's success: Corrections is committed to our community – understanding individuals, instilling hope, embracing change, and providing opportunities.

IMPORTANT NOTES:

Please include a minimum of three (3) professional references with your application.

A professional reference is defined as an individual who has been paid to supervise your work and can attest to your work performance, technical skills, and job competencies.

If you do not have any or sufficient professional references, please include non-related professionals, such as educators or other professional associates.

**Please note: Phone number AND email address are required for all professional references.

A background check including criminal record history will be conducted prior to a new hire. Information from the background check will not necessarily preclude employment but will be considered in determining the applicant’s suitability and competence to perform in the position.
Employees may work directly with or near incarcerated individuals in a potentially hazardous setting. Please consider this when deciding whether to apply.

We are committed to maintaining a drug and alcohol-free work environment, and our employees are expected to comply with all state and federal laws.

A pre-employment drug test may be administered as part of the selection process, and applicants who test positive for any controlled substances, will be disqualified from consideration.

Oleoresin Capsicum (OC) is an aerosol pepper spray made available as a means of self-defense and/or de-escalation. Applicants with sensitivities or allergies are encouraged to ask about the level of exposure they could expect in this position.
Animal care projects are a common component of most Washington State prisons, including dog and cat programs. Applicants with animal sensitivities or allergies are encouraged to ask about the level of exposure they could expect in this position.

Tuberculosis (TB) is a priority health issue for DOC employees. The successful candidate may be required to provide valid proof of a baseline TB skin test within 60 days from the date of hire.

When positive tests result, further information, testing and treatment will also be required. Employment is not contingent upon test results.

This position may be represented by a bargaining unit.

Requires respirator medical evaluation questionnaire, fit testing, training, and use of respiratory protection as required by the WA Industrial Safety & Act standards. Refer to WAC 296-842 to learn more.
Must be able to work in spaces, climb stairs, walk long distances, and frequently lift up to 30 pounds. Under rare circumstances this position may be required to lift or carry up to 50 pounds and push up to 100 pounds.

Foreign equivalent degrees awarded outside the United States must have a credential evaluation report attached to your application.

You may request the required evaluation/documentation from www.wes.org and www.aice-eval.org. Until this documentation is provided, you will not be selected to move forward in the hiring process.

Candidates who are offered a job with the Department of Corrections must possess work authorization that does not require sponsorship by the employer for a visa now or in the future.

(FOR RN POSITIONS) Salary is based on experience and is determined at the time a final offer of employment is made. The salary range listed in the job posting includes Steps A-U.

Step U is a longevity step and is typically gained six years after being assigned to Step T in your permanent salary range.

(FOR ALL OTHER NON WMS POSITIONS) Salary is based on experience and is determined at the time a final offer of employment is made. The salary range listed in the job posting includes Steps A-M.

Step M is a longevity step and is typically gained six years after being assigned to Step L in your permanent salary range.

DOC complies with the employment eligibility verification requirements for the federal employment eligibility verification form I-9.

The selected candidate must be able to provide proof of identity and eligibility to work in the United States consistent with the requirements of that form.

https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents

DOC does not use E-Verify; therefore, we are not eligible to extend STEM-Optional Practice Training (OPT). For information, please visit www.uscis.gov.

We are committed to hiring individuals who possess core diversity competencies:

Foster a positive attitude and openness toward the ever changing social and cultural makeup of the workplace.

Work effectively with people of different perspectives, abilities, disabilities, races, religions, ages, lifestyle preferences and social, ethnic and cultural backgrounds.
Respectfully acknowledge people's differences and recognize these differences as important and valuable.
Promote inclusiveness.
Be culturally sensitive and appropriate.
Respect and value diverse backgrounds and traditions.

What We Offer:

As an employee of the Department of Corrections, your work-life integration is a priority.

Washington State employees are offered one of the most inclusive and competitive benefits packages in the nation.

Besides comprehensive family insurance for medical, dental, and vision, these perks also may include:

Up to 25 paid vacations days a year
8 hours of paid sick leave per month
12 paid holidays a year
Generous retirement plan
Flex Spending Accounts
Dependent Care Assistance
Deferred Compensation and so much more!

Many DOC jobs are covered by the Public Safety Employees' Retirement System (PSERS).

If someone moves from a Public Employees Retirement System (PERS) eligible position to a PSERS eligible position, they actually retire under two different systems/plans.

For more information, please contact the Department of Retirement System at: 1-800-547-6657.

DOC is an equal opportunity employer and does not discriminate on the basis of race, creed, color, national origin, sex, marital status, sexual orientation, gender identity, gender expression, age, honorably discharged veteran, veteran status, genetic information, or the presence of any sensory, mental or physical disability or the use of a trained guide dog or service animal by a person with a disability.

For questions about this recruitment, or to request reasonable accommodation in the application process, please email kathey.waggoner@doc1.wa.gov or call at (509) 907-7808.

For TTY service, please call the Washington Relay Service at 7-1-1 or 1-800-833-6388.

✓ Fresh Listing

Medical Assistance Specialist 3 - PN97 & PN98 - HQ

Job Description

Summary

Key Requirements

Full Job Description

Requirements

Qualifications

Additional Information

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