Administrative Specialist/Appeals Administrative Specialist

Agency
Dept of Health and Human Services
Division
HEALTH BENEFITS
Job Classification Title
Administrative Specialist I (S)
Position Number
65024479
Grade
NC08
About Us
The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence.
Description of Work
The primary purpose of this position is to provide administrative support to the Due Process operations and Appeals Team. Subject areas for Administrative Specialist I include provider reconsiderations, expedited hearing requests, Medicaid Direct and Managed Care appeals. This position also maintains documentation of activities, reports, correspondence, policies, and communication files. This position works directly with handling telephone inquiries, expedited appeal requests, statistical reports, contract management, provider reconsideration requests, and internal operations. The support activities include answering and responding to telephone calls/messages/emails, collecting and distributing mail, drafting beneficiary and vendor correspondence, preparation of calendar meetings and their applicable attachments, filing, copying, scanning, formatting reports, and other activities as directed.
Knowledge Skills and Abilities/Management Preferences
Salary Grade Range $39,244 - $68,679
Recruitment Range $39,244 - $47,210
Candidates now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement.
The Knowledge, Skills, and Abilities (KSAs)/ Management Preferences are not required. Applicants who possess the following skills are preferred:
Experience with customer outreach
Experience with creating data reports
Experience with contract management
Experience with billing or payment of medical claims
Physical Requirements:
Able to lift 20 pounds
Posting closes at 11:59 p.m. the night before the closing date
Position is funded in part through federal funds
About Us
The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence.
About the NC Division of Health Benefits:
The Division of Health Benefits (DHB) within NCDHHS is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. DHB manages and oversees North Carolina Medicaid and other programs that provide access to services and supports for parents, children, seniors, people with intellectual / developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget over $27 billion in state and federal funds per fiscal year, DHB ensures that more than 108,000 enrolled providers are reimbursed for delivering covered services to 3.1 million beneficiaries.
All positions in the Division of Health Benefits are exempt from the State Human Resources Act (G.S. 126) except for the provisions of Articles 6 and 7 per HB 372 Section 20.
Compensation and Benefits:
The State of North Carolina offers excellent comprehensive benefits. Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis). Employees also receive paid vacation, sick, and community service leave. In addition, paid parental leave is available to eligible employees. Visit website for benefits.
Supplemental Contact Information:
The North Carolina Department of Health and Human Services (DHHS) is an Equal Opportunity Employer that embraces an Employment First philosophy, which consists of complying with all federal laws, state laws, and Executive Orders. We are committed to reviewing requests for reasonable accommodation at any time during the hiring process or while on the job. For more information about DHHS: https://www.ncdhhs.gov/.
DHHS uses the Merit-Based Recruitment and Selection Plan to fill positions subject to the State Human Resources Act with the most qualified individuals. Hiring salary will be based on relevant qualifications, internal equity, and budgetary considerations pertinent to the advertised position.
In accordance with the Governor’s Executive Order 303, our agency supports second-chance employment for individuals who were previously incarcerated or justice-involved. We invite all potential applicants to apply for positions for which they may be qualified.
Application Process
Be sure to complete the application in its entirety. Resumes will not be accepted in lieu of completing this application.
Information should be provided in the appropriate areas, to include the following: Education, including high school and all degrees obtained, Work Experience, and Certificates & Licenses. It is critical to our screening and salary determination process that applications contain comprehensive candidate information.
Answers to Supplemental Questions are not a substitute for providing all relevant information within the body of your application. To receive credit for the supplemental questions, you must provide supporting information within the "Work Experience" section of the application to support your answers.
If multiple applications are submitted to an individual posting, only the most recent application received prior to the closing date will be accepted. Applications must be submitted by 5:00 PM on the closing date.
Applicants may be subject to a criminal background check. All candidates selected for positions considered "Positions of Trust" will be subject to a criminal background check.
Due to the volume of applications received, we are unable to provide information regarding the status of your application over the phone. To check the status of your application, please log in to your account. Upon the closing date, applications are "Under Review" and will be screened by Human Resources for qualified applicants. The hiring process may take several weeks.
Degrees must be received from appropriately accredited institutions. Transcripts and degree evaluations may be uploaded with your application. The State of North Carolina/Office of State Human Resources uses the National Association of Credential Evaluation Services (NACES) as a referral resource for applicants who need to have their credentials certified as equivalent.
For a list of organizations that perform this specialized service, please visit the NACES membership website at https://www.naces.org/members.
Degree/College Credit Verification
Degrees must be received from appropriately accredited institutions. Transcripts, degree evaluations and cover letters may be uploaded with your application.
Veterans’ and National Guard Preference
Applicants seeking Veteran's Preference must attach a DD-214 Member-4 Form (Certificate of Release or Discharge from Active Duty) to their applications.
Applicants seeking National Guard Preference must attach an NGB 23A (RPAS), along with the state application, if they are a current member of the NC National Guard in good standing.
Applicants who are former members of either the NC Army National Guard or the NC Air National Guard, with honorable discharge and six years of creditable service, must attach a copy of their DD 256 or NGB 22, along with the state application.
ADA Accommodations
Consistent with the Americans with Disabilities Act (ADA) and the Pregnant Workers Fairness Act (PWFA