Medical Benefits Reviewer 5-E7

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).

To be considered for this position you must:

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

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 high-speed internet connection of at least 25 Mbps download and 5 Mbps upload.
• Suitable lighting, furniture, and utilities
• A secure work location that allows privacy and prevents distractions.

As a Condition of Employment: this position requires successful completion of a background investigation and a criminal records check.

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.

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.

If you previously held status in this classification and departed within the last three (3) years, please contact Human Resources regarding your interest in a potential reinstatement. Reinstatement is not guaranteed or required.

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

State employment also offers rewarding careers where you can help Michiganders enjoy better lives. Many State of Michigan jobs offer alternate work schedules and remote-work options that can help give the flexibility you need. In 2022, Forbes ranked the State of Michigan in the Top 10 of America’s Best Employers For New Grads and as the #1 employer for new grads in government services. More details on benefits for our new hires are below:

Rewarding Work: State of Michigan jobs allow you to serve Michiganders in many different ways depending on your interests and skills. Help preserve and protect our environment and the public health; enforce state laws and regulations; advocate for children, families, and victims of discrimination; support our state’s military and veterans; rebuild our state’s infrastructure; or support other state agencies through our fiscal, IT, and HR systems.

Insurance Benefits: The State of Michigan offers health, mental health, dental, and vision insurance to eligible career employees, their spouses, and their children. The state also covers a life-insurance benefit of two times employees’ annual salary (up to $200,000). The state also offers long-term-disability insurance that can provide continuing benefits if an injury or illness prevents employees from working. More information is available at www.mi.gov/employeebenefits.

Retirement Programs: The State of Michigan offers 401(k) and 457 plans for new hires to save for retirement. The state will automatically contribute an amount equal to 4% of your pay to a 401(k) account. The state will also match up to 5% of your pay if you contribute to your 401(k) account. Your contributions vest immediately, and the state’s contributions fully vest after just 4 years. More information is available at http://www.mi.gov/orsstatedc.

Vacation and Sick Leave: Eligible full-time employees receive between 15 and 35 personal days and 13 sick days per year that may be rolled over to the following year if not used. Eligible employees also receive an additional day each year for community service or school functions.

Paid Parental Leave: Eligible employees can take 12 weeks of paid leave immediately after a birth or adoption to allow needed time together at home with a new child.

Paid Holidays: Eligible employees receive 13 or 14 paid holidays each year including New Year’s Eve and Day, Martin Luther King Jr. Day, Presidents’ Day, Memorial Day, Juneteenth, the Fourth of July, Labor Day, Election Day, Veterans Day, Thanksgiving, Thanksgiving Friday, Christmas Eve and Day.

Bonus Programs: Eligible employees with five years of service also receive annual longevity bonuses that grow as seniority increases. Some positions also may qualify for recruitment, retention, and performance bonuses or other special pay premiums.

Military Pay Differential: Employees in the guard or reserves may also qualify for supplemental pay benefits if miliary pay during qualifying duty is less than normal state pay. Prior military service may also allow seniority credits to accelerate eligibility for longevity bonuses and additional personal leave accrual.

Tax-Advantaged Programs: In addition to 401(k) and 457 retirement accounts, the state also offers flexible spending account (FSA), health savings account (HSA), and qualified transportation fringe benefit (QTFB) programs that can help you save money by reducing your taxable income.

Student Loan Forgiveness: Working for the State of Michigan may allow you to participate in programs that forgive the balance of qualifying student loans. Information to help determine if you could qualify is available from the U.S. Department of Education.

Tuition Reduction: Some colleges and universities offer savings to eligible employees and family members to further their education while working for the State of Michigan.

Professional Development: To help develop your career, programs are available to apply for reimbursement of up to $2,000 a year for education and training for college course credits and non-degree programs.

Alternative and Remote Work Schedules: Depending on the nature of their duties, many state jobs offer flexible work schedules and remote or hybrid telecommuting options that can help obtain the work-life balance that you seek.

Great Lakes and Great Times: Michigan boasts four Great Lakes, 11,000 inland lakes, 36,000 miles of rivers and streams, 20 million acres of forests, 100 state and national parks and recreation areas, 1,300 miles of bike trails, 6,500 miles of snowmobile trails, the second-most ski areas in the nation, 650 public golf courses, 600 campgrounds, and an international dark-sky park—just for starters. Our cities offer concerts and cultural events, storied sports teams, education hubs, vibrant downtowns, one-of-a-kind craft beverages, and renowned restaurants for every appetite. From urban centers to beach towns to the great outdoors, the opportunities are endless. With your state salary and benefits and Michigan’s affordable cost of living, you can explore all that Michigan has to offer.

Updated: 11/14/2022