COBCO Health Insurance Specialist; MAS​/AHSO

COBCO Health Insurance Specialist (MAS3/AHSO)

This position investigates and researches cases of Medicaid billing to determine whether third party liability coverage should have been used. The goal of this work is to ensure that Medicaid has been the payer of last resort, to ensure proper use of these public funds. This work requires delving into situations to find new information and wade through ambiguity with a goal of ensuring medical costs being covered by the correct entities.

If you are a problem solver who likes to ask questions and dig deep to uncover issues or explore curiosities, this may be the position for you!

All HCA employees will apply an equity lens to their work, which may include but is not limited to all analyses of core business and processes.

The organization’s mission is to provide high quality health care through innovative health policies and purchasing strategies. The Apple Health Services and Operations (AHSO) Division works across the Health Care Authority (HCA) and in partnership with the health care community at local, state and federal levels, in order to develop, and manage high quality, and evidence-based health care programs and purchase services that enhance Washington State’s citizens’ ability to access appropriate, quality health care.

This position resides in the Health Insurance Unit (HIU) within the Coordination of Benefits and Claims Office (COBCO) and supports HCA’s vision for a healthier Washington via both health purchasing strategies as well as customer-centered service. This position investigates and verifies potential third party liability (TPL) coverage leads and integrates third party liability coverage into the Provider One MMIS, to ensure cost avoidance or cost recovery of Medicaid expenditures, assuring Medicaid will be the payer of last resort.

TPL refers to the legal obligation of third-party health care sources to pay for a claim for a Medicaid client before Medicaid pays the claim. In this position, staff independently provide expert consultative services to providers and clients, both orally and in writing, concerning coordination of TPL and Medicaid benefits.

The default assigned work location of all Health Care Authority (HCA) positions – both on-site and telework eligible positions – is within the State of Washington. This position reports to Olympia, WA. Frequency of onsite work will vary based on business and operational needs. All agency employees are required to report on-site in Olympia on their first and last days of employment to pick up and return state‑issued equipment, regardless of telework status or location.

Employee benefits are not just about the kind of services you get, they are also about how much you may have to pay out of pocket. Washington State offers one of the most competitive benefits packages in the nation. We understand that your life revolves around more than just your career. Like everyone, your first priority is ensuring that you and your family will maintain health and financial security.

That's why choice is a key component of our benefits package. We have a selection of health and retirement plans, paid leave, staff training and other compensation benefits that you can mix and match to meet your current and future needs.

• Insurance Benefits:
  Employees and their families are covered by medical (including vision), dental and basic life insurance. There are multiple medical plans with affordable monthly premiums that offer coverage throughout the state.
• Insurance Benefits:
  Staff are eligible to enroll each year in a medical flexible spending account which enables them to use tax‑deferred dollars toward their health care expenses. Employees are also covered by basic life and long‑term disability insurance, with the option to purchase additional coverage amounts.
• Insurance Benefits:
  To view premium rates, coverage choice in your area and how to enroll, please visit the Public Employees Benefits Board (PEBB) website. The Washington Wellness program from the Health…