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Job Description
The MDHHS mission is to provide opportunities, services, and programs that promote a healthy, safe, and stable environment for residents to be self-sufficient. We are committed to ensuring a diverse workforce and a work environment whereby all employees are treated with dignity, respect and fairness. For more information, please visit our MDHHS Diversity, Equity, and Inclusion Plan. (Download PDF reader)
This position functions as a Medical Benefits Reviewer and is responsible for the receipt and distribution of written, faxed, and electronic prior authorization requests for the processing of prior authorization of services and medical treatment as allowed by Medicaid rules and policies. These inquiries are from providers regarding Medicaid fee-for-service and Children Special Health Care Services programs. This position is responsible to prepare and properly retain and dispense protected confidential information adhering to HIPAA standards. The employee must exercise independent judgment in selecting a course of action based on established technical medical procedures, reimbursement techniques and coding procedures.
Position Description (Download PDF reader)
Job Specification (Download PDF reader)
To be considered for this position you must:
apply for this position online via NEOGOV; click on “Apply” in the job posting for instructions on submitting your electronic application. Hard copy applications are not accepted.
relevant experience and/or education referred to in supplemental questions must be documented in resume, transcript and/or application to allow for accurate screening.
attach a resume identifying specific experience and dates of employment. Dates of employment should include month and year and hours per week.
attach a cover letter.
if applicable, attach a copy of an official transcript(s). We accept scanned copies of official transcripts. We do not accept web-based, internet, or copies of unofficial transcripts. Official transcripts provide the name of the institution, confirmation that a degree was awarded and on what date, and the registrar’s signature.
Failure to complete any of the above items may result in your application not being considered. See instructions for attaching files here: Instructions (Download PDF reader)
Required Education and Experience
Education
Educational level typically acquired through completion of high school.
Experience
Medical Benefits Reviewer 5 – No specific type or amount is required.
Medical Benefits Reviewer 6 – One year of administrative support experience.
Medical Benefits Reviewer E7 – Two years of administrative support experience, including one year equivalent to a Medical Benefits Reviewer 6, involving the processing of medical benefits claims.
Alternate Education and Experience
Possession of a certificate from a Medical Assistant program may be substituted for one year of experience processing medical claims.
Additional Requirements and Information
Your application for any position does not guarantee you will be contacted by the Department/Agency for further consideration. Only those applicants interviewed will be notified of the results.
Position Location/Remote Office: This position is located at Capitol Commons Center, 400 S Pine St, Lansing 48933 and the selected incumbent will be required to physically report to this office. Candidates should confirm work location and schedule at the time of interview.
Employees will be provided computers to perform state work. Phones may also be provided for necessary communications. If working remotely, employees will be responsible for providing other components of a remote office at their own expense, including:
A secure work location that allows privacy and prevents distractions.
A high-speed internet connection of at least 25 Mbps download and 5 Mbps upload.
Suitable lighting, furniture, and utilities
As a Condition of Employment: this position requires successful completion of a background investigation and a criminal records check.
The Department of Health & Human Services reserves the right to close this posting prior to its original end date once a sufficient number of applications have been received.
For information about this specific position, please email [email protected]. Please reference the job posting number in subject line.
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State employment benefits include everything from health insurance to retirement income and can be worth 25% to 50% of salary depending on wages and benefits.This page briefly explains some benefits provided under Civil Service rules or union contracts.Leave TimeFull-time employees receive between 15 and 35 vacation days per year. Employees also receive 13 sick days per year and 8 hours of leave to participate in certain school functions or community activities. Employees may also qualify for up to 12 weeks of paid or unpaid leave for certain family or medical situations.HolidaysState employees receive 12 or 13 scheduled paid holidays each year, including New Year’s Eve, New Year’s Day, Thanksgiving, Christmas Eve, Christmas Day, Memorial Day, and Veterans Day.Alternative Work SchedulesFlexible work schedules and telecommuting options are available in many jobs.Insurance and Other BenefitsEligible employees can choose from a variety of health insurance plans, including a PPO, HMOs, and a High Deductible Health Plan with HSA (effective January 1, 2021). Other coverage includes vision, dental, life, and long-term disability insurance, as well as tax-deferred Flexible Spending Accounts (FSAs) for health, prescription, dental and vision eligible expenses, dependent care expenses, and Qualified Transportation Fringe Benefits (QTFB). Employees also have the option to purchase additional life, accidental death, and long-term care insurance, auto/home insurance, identify theft protection, and legal services.Paid Parental LeaveProvides eligible individuals up to 12 weeks of paid leave immediately following birth or adoption of a child.Deferred CompensationEmployees may invest income in a tax-deferred retirement investment program. The state offers two optional deferred compensation plans, the 457 and 401(k). Employees decide the amount deducted from their paychecks.RetirementEmployees receive a minimum 4% state contribution toward their retirement fund. If an employee elects to contribute more, the state will match up to 3%. The Office of Retirement Services administers two different retirement plans for State of Michigan employees: Defined Benefit (DB) and Defined Contribution (DC). New hires can also receive up to a 2% employer match into a Personal Healthcare Fund and a lump-sum credit to a tax-deferred account if eligible. More information is available at the Office of Retirement Services.
