Insurance Analyst

Title: Insurance Analyst

State Role Title: Health Care Compliance Spec I

Hiring Range: $60,727 - $62,878

Pay Band: 4

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 an Insurance Analyst. The selected competitive candidate will provide exceptional delivery of services to the agency's Program Operations Division.

Job responsibilities will include, but are not limited to:

Determines eligibility and cost effectiveness of new applicants for the Premium Payment Programs: Health Insurance Premium Payment (HIPP)/HIPP for Kids Program and FAMIS Select.

Case management of assigned active HIPP/HIPP for Kids cases, to include processing health insurance premium assistance payments on a monthly basis to HIPP/HIPP for Kids recipients in accordance with established guidelines.

Applicants and enrollees may include COBRA, disabled children, and self-employed coverage policies.

In addition, processes payments related to cost sharing and reimbursements of co-pays, deductibles, and coinsurance for the Medicaid eligible parent(s) and children for services covered under the state plan.

This position is responsible for the privacy and security of Protected Health Information (PHI) and for maintaining reasonable and appropriate safeguards to ensure the confidentiality, integrity, and appropriate release of all PHI; protect against reasonable anticipated threats or hazards to PHI; protect against reasonable anticipated unauthorized uses or disclosure of PHI; protect PHI transmitted or maintained in any form or medium and ensure proper use of secure email at all times so that there is no inappropriate release of disclosure of PHI. Any privacy or security violations must be reported to the HIPAA Office Privacy and Security Office.

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:

Experience in comparisons of private health insurance coverages/practices and individual services to Medicaid state plan rates.

Experience in financial calculations and the determination of cost sharing for cost-effectiveness after reviewing medical information and insurance information.

Knowledge and experience interpreting, applying, and communicating HIPAA, federal and state regulations and policies regarding health care to external stakeholders.

Experience interpreting and developing program processes and improvements.

Experience operating a personal computer with word processing and spreadsheet software.

Experience interpretation and application of federal, state laws/regulations.

Experience in meeting deadlines.

Experience with internal/external stakeholders.

Additional Considerations

Competitive candidates should meet these additional considerations:

Knowledge of various medical programs, including but not limited to, COBRA, self-employed coverages, and Medicare.

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 Virginia Department of Medical Assistance Services (DMAS) does not offer employment-based Sponsorship. Selected candidates will have their work authorization completed using the E‐Verify Program.

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.

This position requires a fingerprint based Criminal History Background Check, Education Checks if applicable, 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.

In support of the Commonwealth's commitment to inclusion, we are encouraging individuals with disabilities to apply through the Commonwealth's Alternative Hiring Process. To be considered for this opportunity, applicants will need to provide their AHP Letter (formerly called a Certificate of Disability) provided by the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Service-Connected Veterans may also apply via the AHP if they also provide an AHP Letter. To request an AHP Letter, use this link: https://www.dars.virginia.gov/drs/cpid/PWContact.aspx or call DARS at 800-552-5019, or DBVI at 800-622-2155

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: askhcdtalentacq@dmas.virginia.gov

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 AHP Letter (formerly COD) provided by the Department for Aging & Rehabilitative Services (DARS), or the Department for the Blind & Vision Impaired (DBVI). Service-Connected Veterans are encouraged to answer Veteran status questions and submit their disability documentation, if applicable, to DARS/DBVI to get their AHP Letter. Requesting an AHP Letter can be found at AHP Letter or by calling DARS at 800-552-5019.

Note: Applicants who received a Certificate of Disability from DARS or DBVI dated between April 1, 2022- February 29, 2024, can still use that COD as applicable documentation for the Alternative Hiring Process.