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HUMAN SERVICES PROGRAM SPECIALIST - 68058971

Date: Dec 4, 2017

Location: SAINT PETERSBURG, FL, US, 33701

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Requisition No: 25449 

Agency: Agency for Health Care Administration

Working Title: HUMAN SERVICES PROGRAM SPECIALIST - 68058971

Position Number: 68058971 

Salary:  $1,257.57 (Minimum) Bi-Weekly 

Posting Closing Date: 12/17/2017 

Must be fluent in both verbal and written communication  This is a highly responsible position in in the St. Petersburg Medicaid Field Office, Recipient Enrollment Support Unit, within the Bureau of Recipient and Provider Assistance within the Division of Medicaid, Agency for Health Care Administration. The incumbent in this position is responsible for researching and responding to recipient requests for assistance and for Recipient Enrollment Support Center functions such as county code errors, file problems and unable to locate as set forth in State Statutes, rules, policies and Code of Federal Regulations. The incumbent in this position is also responsible for researching and responding to recipient issues and concerns, as well as providing technical assistance to help recipients understand Medicaid coverage policy and assure that recipients receive proper care.

 

The incumbent in this position handles duties associated with the Recipient Enrollment Support Unit. This includes, but is not limited to county code errors, file problems and unable to locate. Receives county code errors from Headquarters, plans, recipients, providers and other staff. Researches the error using FMMIS, FLORIDA and Health Track. Communicates with DCF, SSA and/or the recipient in order to resolve. Receives file problems and segment update requests from Headquarters, plans, recipients, providers and other staff. Researches the problem using FMMIS, FLORIDA and Health Track. Communicates with Headquarters and the recipient in order to resolve. Receives unable to locate reports from Headquarters and the plans. Researches the current recipient address using FMMIS, FLORIDA and Health Track. Sends results back to the plan and segment update requests to Headquarters as part of the resolution.

 

The incumbent shall maintain knowledge about the Medicaid State Plan, waivers, regulations, and processes. The incumbent will explain the differences between partial Medicaid programs, Fee-For-Service (FFS), and SMMC and assist recipients by explaining their options. The incumbent will research, resolve and respond to Medicare premium payment issues, changes to Part A and B coverage, and corrections to Medicare numbers. The incumbent researches, resolves, and responds to Third Party Liability (TPL) file maintenance and claims issues. The incumbent shall also research, resolve, and respond to beneficiary billing issues and concerns as well as work with providers to resolve complex recipient issues.

 

* Preference will be given to bi-lingual applicants. Spanish preferred.

 

KNOWLEDGE, SKILLS, AND ABILITIES

  • Knowledge of Medicaid and/or Medicaid eligibility policies and procedures.
  • Ability to communicate effectively verbally and/or in writing.
  • Skill in the operation of personal computers and knowledge of software programs such as Microsoft Word, Excel, Outlook and Internet Explorer.
  • Ability to utilize problem solving techniques.
  • Ability to plan, organize and coordinate work assignments effectively.
  • Ability to establish and maintain effective working relationships with co-workers and other professionals.
  • Skill to provide quality customer service and the ability to work with difficult individuals utilizing de-escalation techniques as needed.

     

    MINIMUM QUALIFICATIONS REQUIREMENTS

  • Three years of experience analyzing, researching and resolving customer issues related to government and/or private health insurance.
  • A bachelor’s degree from an accredited college or university is preferred and may substitute for one year of the required experience.
  • Professional or non-professional experience can substitute on a year-for-year basis.

     

    CONTACT: JOYCE CARPENTER (727) 552-1909

     

The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.

Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.

The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.

VETERANS’ PREFERENCE.  Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans’ Preference will receive preference in employment for Career Service vacancies and are encouraged to apply.  Candidates claiming Veterans’ Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code.  Veterans’ Preference documentation requirements are available by clicking here.  All documentation is due by the close of the vacancy announcement. 


Nearest Major Market: Tampa