Appeals Coordinator

Experience:Seven years of administrative or professional experiencedeveloping or applying policies and regulations in medical assistance health insurance federal or State entitlement programs.

Notes:

1. Candidates may substitute the possession of a Bachelors degree from an accredited college or university and three years of administrative or professional experience developing or applying policies and regulations in medical assistance health insurance federal or State entitlement programs for therequired experience.

2. Candidates may substitute the possession of a Masters degree from an accredited college or university in the relatedfield of work for the required experience.

may substitute U.S. Armed Forces military service experience as a commissioned officer in OperationalAnalysis classifications or Health Services Management specialty codes in the health-related field of work on a year-for-year basis for the required experience.

• Experience interpreting and applying federal and state Medicaid regulations policies and procedures related to provider and recipient appeals sanctions exclusions and terminations.
• Experience coordinating administrative appeals and ensuring compliance with procedural requirements including preparing reports case documentation and recommendations for program staff.
• Experience using Medicaid-related databases and information systems such as the Maryland Medicaid Information System (MMIS) Long Term Services and Supports (LTSS) In Home Supports and Assurances (ISAS) Medicaid Appeals Database and Medicaid Provider Database or comparable healthcare program systems.
• Experience collaborating with federal agencies state Medicaid programs and internal stakeholders to exchange program integrity information implement regulatory requirements and support provider enrollment exclusion and sanction activities.
• Strong analytical organizational and communication skills with experience developing process improvements interpreting complex regulations and participating in the implementation or enhancement of healthcare information systems.

Applicants who meet the minimum (and selective) qualifications will be included in further evaluation. The evaluation may be a rating of your application based on your education training and experience as they relate to the requirements of the it is essential that you provide complete and accurate information on your report all related education experience dates and hours of indicate your college degree and major on your application if applicable. For education obtained outside the U.S. any job offer will be contingent on the candidate providing an evaluation for equivalency by a foreign credential evaluation service prior to starting employment (and may be requested prior to interview).

Complete applications must be submitted by the closing submitted after this date will not be added.

Incorrect application forms will not be will not be accepted in lieu of a completed application.

Candidates may remain on thecertified eligible list for a period of at least one year. The resulting certified eligible list for this recruitment may be used for similar positions in this or other State agencies.

STATE OF MARYLAND BENEFITS

Online applications are highly recommended. However if you are unable to apply onlinethe paper application (and supplemental questionnaire) may be submitted to MDH Recruitment and Selection Division 201 W. Preston St. Room 114-B Baltimore MD application materials must be received by 5 pm close of business on the closing date for the recruitment no postmarks will be accepted.

If additional information is required the preferred method is to upload. If you are unable to upload please fax the requested informationto .Only additional materials that are required will be accepted for this recruitment. All additional information must be received by the closing date and time.

For questions regarding this recruitment please contact theMDH Recruitment and Selection Division at .

If you are having difficulty with your user account or have general questions about the online application system please contact the MD Department of Budget and Management Recruitment and Examination Division at or.

Appropriate accommodations for individuals with disabilities are available upon request by calling: or MD TTY Relay Service 1-.

We thank our Veterans for their service to our country.

People with disabilities and bilingual candidates are encouraged to apply.

As an equal opportunity employer Maryland is committed to recruitment retaining and promoting employees who are reflective of the States diversity.

MDHMedCare