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GENERAL SUMMARY OF POSITION:

The Premium Assistance program operates within the Third Party Liability Unit at the Center for Health Care Financing and administers this program for the Massachusetts Medicaid Program, MassHealth.

Premium Assistance programs permit MassHealth to pay health insurance premiums for eligible MassHealth members with access to employer sponsored health insurance.

Under the general direction of the Senior Manager, the Premium Assistance Coordinator will assist in the coordination of daily operations of the program and seek to maximize benefits for eligible MassHealth members in order to preserve MassHealth as the payor of last resort.

The Benefit Coordination and Recovery Unit (BC&R) within the Center for Health Care Financing conducts business services for the Executive Office of Health and Human Services (EOHHS) to maximize revenue for the Commonwealth of Massachusetts. Our services range from program analysis and consultation to hands-on claims preparation. Our consultants have an extensive understanding of government health financing structures and are well versed in the most current developments in federal, state and local legislation and regulations.

MAJOR RESPONSIBILITIES:

• Analyze data and resolve discrepancies internally for assigned projects/reports
• Review  and may perform ,billing, claim generation collection and identification activities
• Respond to inquiries from EOHHS and other staff concerning assigned projects
• Work on revenue management projects
• Develop spreadsheets, data bases and/or systems to track project programs
• Perform related duties such as preparing and presenting assigned reports, policy changes, and technical updates to staff frequently an effectively
• Work individually as well as being a team member
• Research, gather and report upon statistical analysis and data
• Assist in cross training opportunities for co-workers and new staff
• Participate in quality control measures for both current and future contract obligations with internal and external vendors
• Participate in professional training as well as cross training activities to enhance performance and skill set
• Participate in continuous quality improvement initiatives and projects
• Foster compliance with state and federal regulations
• Preserve confidential, protected health and personally identifiable information and files
• Performs other duties as assigned

REQUIRED QUALIFICATIONS:

• Bachelor’s degree in Business/Health related discipline or equivalent experience
• 3 years experience in accounting, finance or public administration
• Knowledge of funding and revenue sources for health and human service programs
• Working knowledge of Microsoft Office including Word, Power point, Access and Excel Programs
• Ability to communicate effectively in both written and verbal formats
• Excellent Customer Service Skills
• Knowledge of the federal and Massachusetts state regulations associated with federal entitlement and commercial health insurance programs

PREFERRED QUALIFICATIONS

• Extensive knowledge of MassHealth Eligibility and MassHealth Coverage
• Extensive knowledge of MassHealth’s eligibility systems
• Strong quantitative and analytical skills
• Exceptional organizational skills
• Familiar with the ACA Healthcare changes and how it relates to Medicaid Programs
• Previous experience communicating professionally and effectively with public sector personnel, businesses, legal representatives, or private citizens