Washington State Medical Assistance Specialist 3 (MEDS) in Olympia, Washington


Medical Assistance Specialist 3 (MEDS)** Full-Time, Non-Permanent Candidate Pool Olympia, WA

The Health Care Authority (HCA) is Washington's largest health care purchaser, responsible for providing comprehensive health coverage to more than 2 million residents through the Public Employees Benefits and Medicaid programs. The agency provides health purchasing leadership, benefiting both public and private sectors with a focus on moving the health delivery system away from volume toward higher value and better outcomes.

The Olympia office is located in downtown Olympia, within walking distance of shops, restaurants, bus lines, and less than one (1) mile from the freeway.

This announcement is for ongoing recruitment for multiple open positions as Medical Assistance Specialist 3 in the Medical Eligibility Determination Services (MEDS) section

Position Objective: This position supports the HCA mission to provide access to medical care for all eligible Washington citizens. The position determines initial eligibility and/or ongoing individual and family medical eligibility for Medicaid Title XIX, Children's Health Insurance Program (CHIP) Title XXI program, and other Medicaid and state funded medical assistance programs available in Washington State.

This position will perform the following work:

  • Independently analyze applications, determine initial and/or ongoing eligibility and authorize benefits for Medicaid programs administered by the Medical Eligibility Determination Services (MEDS) office.
  • Independently determine initial and/or ongoing eligibility for Health Care Authority Medicaid Title XIX, CHIP Title XXI, and other Medicaid and state funded medical assistance programs administered by the MEDS office
  • Apply complex federal and state eligibility regulations published in WAC and RCW to specific household circumstances resulting in accurate eligibility decisions.
  • Use and manage multiple interdependent electronic systems including but not limited to the Automated Client Eligibility System (ACES), HealthPlanFinder, Provider One, Barcode, WebAx, Audit Plus, SharePoint, Microsoft Office, SOLQ, Document Management System (DMS) and Employment Security Department (ESD).
  • Analyze research and resolve complex eligibility issues applying proper rules and procedures with a high degree of independence. Work on programs such as but not limited to:
  • Post Eligibility Reviews (PER's)
  • Alien Emergency Medical (AEM)
  • Citizenship/ Immigration
  • Retro's
  • Spenddowns
  • Appeals
  • Chip Acuity
  • Pends
  • Take Charge
  • Complex Error Codes Conduct interviews over the telephone, in person, and/or through written correspondence with clients, providers and/or third parties to obtain information for required documentation and verification to support program eligibility. Establish effective working relationships with clients and their advocates and manage difficult interactions with tact and diplomacy. Educate clients on qualified health plans.

Answer inquiries, resolve questions, update eligibility records and otherwise maintain and expand access to medical care for eligible Washington citizens.

  • Work in partnership with advocates, providers, Heath Benefit Exchange, other state agencies, community based organizations and other units within HCA to provide clarification, resolve disputes, solve problems, coordinate referrals and/or answer inquiries.
  • Using excellent written and oral communication skills, apply effective customer service techniques and principles to all interactions with customers, their advocates and other stakeholders. Maintain current and thorough knowledge of rules of eligibility for Medicaid programs, managed care and other areas in the Health Care Authority to provide comprehensive responses to questions or concerns from the public and our customers.
  • Take part in trainings and other development opportunities to enhance communication skills.
  • Participate in committees and project teams as requested. Participate in process improvement, team meetings, and employee problem solving to review office procedures and processes to streamline operations to improve performance and customer service in the MEDS office. Participate in specialized on the job training. Attend and complete training courses as directed by the agency. Attend and participate in staff meetings and other development functions.


Required Qualifications:

A Bachelor's degree;


Three years of experience performing the following duties:

  • Researching and analyzing complex rules, regulations, or policies
  • utilizing research and analysis to make determinations, solve problems, or complete work
  • providing direct customer service either in person or via the telephone Candidates must have three years' experience performing each of the duties, but experience may be gained concurrently. In addition to the requirements above, candidates must be proficient at computer keyboarding.

Preferred/Desired Qualifications:

  • experience performing conflict resolution with customers
  • knowledge of Medicaid programs and eligibility
  • experience utilizing Microsoft Office programs such as Outlook, Word, and SharePoint. Please Note the Following:

Application assessment will be ongoing and the hiring authority reserves the right to offer the position at any time during the recruitment process. It is to the applicant's advantage to apply as early as possible.

How to Apply: Failure to follow the application instructions below may lead to disqualification

To apply for this position you will need to complete the application in full within http://careers.wa.gov and attach to your profile before completion:

  • A cover letter
  • Current resume (Not a substitute for the completed application)
  • Three professional references Only candidates who reflect the minimum qualifications on their State application will be considered. Resumes not accepted in lieu of application.

If you have questions about the process, or need assistance, please contact the recruiter listed below before the posting closes. The candidate pool certified for this recruitment may be used to fill future similar vacancies for up to the next six months.

Contact us:

For inquiries about this position, please contact Ryan Dahlstromat 360-725-0945 or email to ryan.dahlstrom@hca.wa.gov.

**Persons under final consideration for initial appointment with HCA are subject to a background check.

Washington State is an equal opportunity employer. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may call the Human Resources Office at 360.725.0945 or emailryan.dahlstrom@hca.wa.gov.

Job Type: Full Time - Non-Permanent

Job Number: 2016-03055

Department: Health Care Authority

Closing: Continuous

Agency: State of Washington

Address: View Job Posting for Agency Information View Job Posting for Location, Washington, 98504.

Website: http://www.careers.wa.gov

Salary: $35,100.00 - $45,684.00 Annually

Location: Thurston County – Olympia, WA