Third Party Liability Agent

Do you want a professional career where you will help ensure that Medical Assistance (MA) programs can continue to fund quality medical services for eligible recipients by recovering expenditures that were wrongly or temporarily paid? Apply for this Third Party Liability Agent position with the Department of Human Services (DHS), Bureau of Program Integrity, Division of Third Party Liability (TPL), Recovery Section. The TPL Division manages the federally mandated cost containment program designed to identify, enforce the use of, and recover from third party benefits available to MA recipients. With our team, your attention to detail and negotiation skills will help you succeed in the review, evaluation, and recoupment of funds related to personal injury and estate recovery claims for DHS. Apply now and help ensure the integrity of MA benefits programs with us!

In this role, you will be responsible for evaluating and recovering cash benefits and Medical Assistance (MA) expenditures against liable third parties, insurers, recipients, and probate estates in cases where these expenditures were incorrectly or provisionally paid. Your work will involve investigating claims for personal injury and estates, interfacing with state and county agencies, and negotiating settlements with attorneys and insurance companies. This includes reviewing and analyzing referrals in order to determine if DHS benefits were inappropriately granted and to identify who is responsible for paying; communicating effectively, both verbally and win writing, with a variety of stakeholders, providers, and interested parties; and working in conjunction with other agencies and offices to facilitate the efficient collection of claims. You will develop and maintain a working knowledge of legal and regulatory aspects of cash and medical benefits as well as participate in special training sessions and research projects.

Our team will rely on you to negotiate settlements by making logical decisions based on the set of factors relevant to each case. This includes employing sound judgment and skilled diplomacy in order to maximize collections and maintain the best interest of the Department. Responsibilities also involve reviewing payments received, resolving any discrepancies, ensuring that collections are credited appropriately, and initiating any other appropriate follow-up measures as needed. Your work will be essential for maintaining the integrity of statistical reports and the accuracy of each person's individual active case record.

Interested in learning more? Additional details regarding this position can be found in the position description.

Work Schedule and Additional Information:

• Full-time employment
• Work hours are 8:00 AM to 4:00 PM, Monday - Friday, with a 30-minute lunch.
• Free parking.
• Telework: You may have the opportunity to work from home (telework) part-time, up to three days per week. In order to telework, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. If you are unable to telework, you will have the option to report to the headquarters office in Harrisburg. The ability to telework is subject to change at any time. Additional details may be provided during the interview.
• Salary: In some cases, the starting salary may be non-negotiable.
• You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.

QUALIFICATIONS

Minimum Experience and Training Requirements:

• Four years of technical experience collecting, reviewing, or evaluating information for program eligibility or insurance limits of liability; or
• A bachelor's degree; or
• An equivalent combination of experience and training.
• Applicants will be considered to have met the educational requirements once they are within three months of graduating with a qualifying degree.

Other Requirements:

• You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency Guidelines.
• You must be able to perform essential job functions.

How to Apply:

• Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education).
• If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.
• Your application must be submitted by the posting closing date. Late applications and other required materials will not be accepted.
• Failure to comply with the above application requirements may eliminate you from consideration for this position.
• All application materials and interview responses must reflect the applicant's own experience, qualifications, and work. Applicants may use generative AI tools for preparation purposes only. Use of AI to misrepresent or falsify information, or to assist during interviews, is not permitted. Review the Guidance for Generative AI Tools & Job Seekers for additional information.

Veterans:

• Pennsylvania law (51 Pa. C.S. *7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to www.pa.gov/agencies/employment/how-to-apply.html and click on Veterans.

Telecommunications Relay Service (TRS):

• 711 (hearing and speech disabilities or other individuals).

If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.

The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.

• Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam).
• Your score is based on the detailed information you provide on your application and in response to the supplemental questions.
• Your score is valid for this specific posting only.
• You must provide complete and accurate information or:
  1. your score may be lower than deserved.
  2. you may be disqualified.
• You may only apply/test once for this posting.
• Your results will be provided via email.