Minimum Qualifications Provisional Qualifications: You must have completed 60 semester credit hours at a regionally accredited college or university, or a paralegal certificate from a school or institute recognized by the American Bar Association, AND one year of experience where more than half your time was spent dealing with the general public in a sales or consumer/customer service or problem resolution capacity.
Duties Description • Respond to consumers and health care providers who contact bureau in writing or through toll free Helpline. Advocate for consumers who are denied health insurance coverage for health care services. Such assistance may include reviewing health care plan contracts and writing appeals, answering questions about managed care and other health issues, and referring consumers and providers to other appropriate agencies or organizations.
• Monitor health plans for violations of state and federal laws.
• Maintain database regarding above consumer and provider complaints and inquiries.
• Assist attorneys with investigations.
• Negotiate with debt collectors, as well as Medical Directors, attorneys, and upper management staff at health plans.
• Assist in the development of health care consumer pamphlets and other written material.
• Answer questions from other bureaus within the department about health care issues handled by the office.
• Answer questions from other agencies regarding issues the bureau handles.
• Assist consumers with physician and hospital billing disputes.
• Answer telephone calls to the Health Care Bureau’s toll free Helpline and handle appropriately, including: answering questions, referring calls to another agency or organization, and conducting intake responsibilities, which include creation of consumer complaint files.
• Prepare, gather, and compile data for reports from Helpline calls to identify cases suitable for enforcement actions.
• Other duties and special projects as assigned.
Additional Comments Candidates appointed provisionally must take and pass the next scheduled Civil Service examination, and be reachable on the resulting eligibility list, or their employment in that position will end.
Some positions may require additional credentials or a background check to verify your identity.
Notes on ApplyingIf interested please send cover letter and resume. Please indicate how you meet the minimum qualifications for the position. Preferred method of applying is via e-mail. Please use reference #50272 in the subject of email.