claims analyst Richmond, VA
Job description
Title: Healthcare Reimbursement Analyst
Hiring Range: $90,000 - $101,480
Pay Band: 6
Agency: Dept of Med Assistance Svcs
Location: Dept of Medical Asst Services
Agency Website: www.dmas.virginia.gov
Recruitment Type: General Public - G
Job Duties
The Department of Medical Assistance Services (DMAS) is excited to offer a competitive opportunity to serve as the Healthcare Reimbursement Analyst in the Capitation Rate Setting Unit. The selected competitive candidate will provide exceptional delivery of services to the agency’s Provider Reimbursement Division.
Job responsibilities will include, but are not limited to:
This position is responsible for developing complex and highly technical payment policy analysis for Medicaid and other programs administered by the Department of Medical Assistance Services.
This position serves as support staff in development, review, and evaluation of methods and policies for rate setting and reimbursement.
As an employee of DMAS you are entitled to the many comprehensive benefits the Commonwealth has to offer. This includes health benefits, 12 paid holidays, paid leave, flexible work schedules, & retirement plans. For more specific details please visit: https://www.dhrm.virginia.gov/employeebenefits
Located in beautiful Central Virginia, the Richmond area puts you just 2 hours from the Blue Ridge Mountains, Virginia Beach and Washington DC. To learn more about the Richmond, VA area visit: https://www.virginia.org/
The Department of Medical Assistance Services (DMAS) is working to improve the health and well-being of Virginians through access to high quality health care coverage.
DMAS wants talented individuals who can align their experience with the mission of the agency and its core values – service, collaboration, trust, problem solving and adaptability.
At the Department of Medical Assistance Services (DMAS) we encourage and promote that you Come as you are | Become who you want to be | That is our promise.
Minimum Qualifications
Competitive candidates will meet these minimum qualifications:
Must have considerable work-related experience developing complex and highly technical payment policy analysis.
Must have considerable work-related experience developing, reviewing, and evaluating methods and policies for rate setting and reimbursement.
Requires considerable work-related experience using spreadsheets for problem solving and project management.
Must be proficient user of statistical software packages and/or relational database languages such as SQL.
Must write effective SAS or SQL programs designed to extract and analyze large volumes of data.
Must have considerable work-related experience researching issues and solving complex problems related to health careservices payment policies.
Must have considerable knowledge of financial analysis and reporting methods.
Must interpret federal and state laws and regulations regarding health care.
Preferred Qualifications:
Competitive candidates should meet these preferred qualifications:
A proficient user of SAS is preferred.
Knowledge of the principals of managed care capitation rate setting a plus.
Knowledge of accounting standards and cost reports is desired.
Knowledge of Medicaid and Medicaid VAMMIS system is preferred.
Focus on health policy issues is desired.
Prefer that candidate have considerable knowledge of health care claims processing and incurred claims analysis.
Prefer candidates with knowledge of public policy analysis, development and interpretation.
Special Instructions:
You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to “Your Application” in your account to check the status of your application for this position.
The Department of Medical Assistance Services (DMAS) is an Executive Branch agency that will adhere to all policies and procedures, to include the Commonwealth’s Department of Human Resource Management Policy 1.61 Teleworking.
You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to “Your Application” in your account to check the status of your application for this position.
This position requires the submission of a Statement of Economic Interest (financial disclosure).
This position requires a fingerprint based Criminal History Background Check, applicable Education Checks, Work History Verification with references.
If you wish to apply for a job with the Department of Medical Assistance Services, an application and/or resume for employment must be submitted electronically through this website.
Mailed, faxed, emailed, or hand-delivered applications/resumes will not be accepted. Consideration for an interview is based solely on the relevant information presented in the state application and/or resume submitted before the closing date.
Applications and/or resumes should include relevant work history which indicates your qualifications for this position.
The Department of Medical Assistance Services practices fair and equal employment opportunity to all employees and applicants in accordance with applicable laws and regulations. It is our policy to prohibit discrimination on the basis of race, sex, color, national origin, religion, sexual orientation, gender identity, age, veteran status, political affiliation, genetics, or disability in the recruitment, selection, and hiring of its workforce. Qualified individuals with disabilities are encouraged to apply.
The Department of Medical Assistance Services is a V3 certified state agency that provides hiring preference to veterans and members of the reserves and/or National Guard in support of executive order 29, (2010). If you are a Veteran or Spouse of a Veteran or Active Military Member, DMAS encourages you to apply and respond accordingly on your state application.
Contact Information:
Name: DMAS Talent Acquisition
Phone: 804-225-4407
Email: [email protected]
In support of the Commonwealth’s commitment to inclusion, we are encouraging individuals with disabilities to apply through the Commonwealth Alternative Hiring Process. To be considered for this opportunity, applicants will need to provide their Certificate of Disability (COD) provided by a Vocational Rehabilitation Counselor within the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Veterans are encouraged to answer Veteran status questions and submit their disability documentation, if applicable, to DARS/DBVI to get their Certificate of Disability. If you need to get a Certificate of Disability, use this link: Career Pathways for Individuals with Disabilities, or call DARS at 800-552-5019, or DBVI at 800-622-2155.
