Benefit Program Senior Specialist 12.10.24

Job Description:

Benefit Program Senior Specialist 12.10.24

Description

The MO HealthNet Division (MHD) is looking for a Benefit Program Senior Specialist to join our team in the Education and Training Unit, located in Cole County.

Job Posting Number: 4617 8310002

Semi-monthly salary: $2,322.31

Annual salary: $55,735.47

Job Location: This position is located at the Howerton State Office Building; 615 Howerton Court.

Why you’ll love this position: This is a responsible and independent position that requires knowledge of the MO HealthNet programs, specifically related to policy, claims, systems, and functions of the various units along with their relationship with one another. You will be responsible for training and educating providers, participants, and DSS team members on MO HealthNet policies and procedures. As you gain experience in this position you will develop expert working knowledge.

• Train providers virtually and in-person on MO HealthNet Programs in proper claim filing.
• Educate providers and others on benefits and limitations of assigned programs.
• Prepare PowerPoints, recordings, and interactive presentations to aid in trainings.
• Continual work in the Medicaid Management Information System (MMIS), state eligibility systems, and Cyber Access and Payment Authorization systems to access data and research complex inquiries and problems to advise providers on correct processes and procedures.
• Initiate MMIS system problem requests for resolution. The position will assist providers by recycling claims and perform online adjustments of provider claims when appropriate.
• The employee in this position will discuss issues/problems that may occur in assigned programs with medical consultants, operations representatives, and reimbursement and utilization review staff.
• Identify and access necessary data, research, and provide consultation in decision making as needed and serve as an expert user to test MMIS system enhancements.
• Act as program liaison with management staff as to reactions to policy changes and/or program difficulties which providers are experiencing.
• Review draft bulletins and policy manuals and provide feedback.
• Identify needs for changes to current claims processing procedures and make proposals for possible solutions to appropriate staff.
• Maintain awareness of current state and federal laws and regulations, MO HealthNet services, bulletins, and inform providers of changes.
• Present to special interest groups (i.e., medical associations) regarding proper claim filing, MO HealthNet policy, and website resources as requested.
• Train/educate agency staff in assigned programs.

Minimum Qualifications:

Bachelor’s degree and 1-3 years of relevant experience. (Substitutions may be allowed.)

Preferred Qualifications:

Attention to detail is essential. Clear, accurate, written, and verbal communication is important, along with a desire to provide excellent customer service. Working knowledge of eMOMED would be beneficial.

Lack of post-secondary education will not be used as the sole basis denying consideration to any applicant.

The State of Missouri offers an excellent benefits package that includes a defined pension plan, generous amounts of leave and holiday time, and eligibility for health insurance coverage. Your total compensation is more than the dollars you receive in your paycheck. To help demonstrate the value of working for the State of Missouri, we have created an interactive Total Compensation Calculator. This tool provides a comprehensive view of benefits and more that are offered to prospective employees. The Total Compensation Calculator and other applicant resources can be found here .

Salary:

$55,735.47 per Year