Claims Examiner

Overview

To be considered for this position you must complete the state application and attach all required documents through the Montana State Careers site tecareers.mt.gov

This position is within the Senior & Long Term Care Division, Nursing Facility Services of the Montana Department of Public Health and Human Services (DPHHS). The role is responsible for the resolution of disputed claims provided to Medicaid recipients by providers, ensuring compliance with state and federal laws concerning Medicaid claims and related issues, and monitoring and verification of staffing/occupancy reports and any deficiencies.

Our mission at DPHHS is serving Montanans in their communities to improve health, safety, well-being, and empower independence. By joining our department, you will have the opportunity to perform meaningful work in public service to our state and its residents.

The State of Montana's comprehensive benefits package includes healthcare coverage, retirement plans, paid vacation, sick leave, holidays, work/life balance, and eligibility to participate in the Public Service Loan Forgiveness (PSLF) program. DPHHS is the largest state agency with a wide range of advancement opportunities.

• Knowledge of general accounting principles.
• General knowledge of medical billing and coding terminology.
• Skill in verifying the accuracy of data.
• Meet minimum qualifications:
• Bachelor’s degree in accounting, business administration, finance, economics, or a closely related field.
• One year of experience in healthcare claims processing.
• Medical coding certification preferred.
• Other combinations of related education and experience may be considered on a case-by-case basis.

To be considered for a DPHHS position, 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 uploaded correctly to your application for this position.

• Resume

Successful applicants will be subject to background checks relevant to the position and must pass reference checks before an offer will be extended. DPHHS is an equal opportunity employer. Women, minorities, and people with disabilities are encouraged to apply. For a copy of the full job description or if you need a reasonable accommodation in the application or hiring process, contact DPHHS Human Resources listed below.

This position is a mandatory reporter of suspect abuse, neglect, or exploitation of individuals over the age of 60 and those with disabilities over the age of 18.

This position may be eligible for partial telework within the state of Montana. Specific conditions will be provided by the supervisor and must adhere to state policy.

This position may be eligible for a statutory $1.00 an hour base pay increase effective July 1, 2026.