State of Michigan

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)

The Medical Benefit Reviewer is responsible for reviewing and resolving system edits on pended Medicaid Claims billed on

the UB04 Claim Form, and submitted electronically through CHAMPS (Community Health Automated Medicaid Payments System).

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 will work remotely. Occasional travel to the office located at 320 S Walnut St. Lansing MI 48933 may be required. 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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MDHHS is proud to be a Michigan Veteran’s Affairs Agency (MVAA) Gold Level Veteran-Friendly Employer