Accountant/Examiner 3 (PN 20014063)

State of Ohio • Columbus, OH

3d

About The Position

About Us: Our mission at the Ohio Department of Health (ODH) is advancing the health and well-being of all Ohioans. Our agency is committed to building a modern, vibrant public health system that creates the conditions where all Ohioans flourish. The Bureau of Maternal, Child, and Family Health (BMCFH) is organized to support families by improving birth outcomes and the health status of women, infants, children, and youth, including children and youth with complex health care needs. Using data and proven practice, the bureau’s programs support the delivery of direct services, linkages and referrals, population-based supports, program evaluation, education, monitoring and quality oversight, and policy and systems development. Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws. What You'll Do: The Complex Medical Help (CMH) program is seeking a detail-oriented professional to support healthcare program operations by analyzing claims, ensuring compliance and improving processes that impact clients and providers.

Requirements

• Completion of undergraduate core coursework in accounting or 2 yrs. exp. in accounting .
• Completion of undergraduate core coursework in business administration, economics, computer science or related field AND 16 semester or 24 quarter hours in accounting.
• 12 mos. exp. as Accountant/ Examiner 2, 66112 with state government exp. commensurate with duties to be assigned.
• Equivalent of Minimum Class Qualifications for Employment noted above.
• ALL ANSWERS TO THE SUPPLEMENTAL QUESTIONS MUST BE SUPPORTED BY THE WORK EXPERIENCE/EDUCATION PROVIDED ON YOUR CIVIL SERVICE APPLICATION.

Nice To Haves

• Bachelors or advanced degree in accounting, business administration, economics, computer science or related field
• Experience in processing health insurance claims (e.g., processing billing, reviewing claims)
• Experience working with third-party payers and coordinating benefits
• Experience working with spreadsheet software (e.g., Excel, Google Sheets)
• Experience working with medical billers/providers, case managers, and/or clients to resolve claims billing issues.
• Experience with Accounts Payable/Receivable

Responsibilities

• Review and audit accounting transactions to ensure accuracy and compliance with state and federal regulations.
• Authorize and process payments for medical claims, billing, and program expenses.
• Analyze claims data to verify completeness, eligibility, and coordination of benefits.
• Investigate and resolve denied or rejected claims, identifying root cuases and recommending solutions.
• Monitor insurance accounts, recievables, and third-party payments to ensure proper processing.
• Ensure compliance with applicable laws, policies and regulations.
• Prepare written analyses, summaries and reports to support desicion-making and process improvements.
• Evaluate claims processing operations and recommend enhancements to imrpvoe efficiency and accuracy.
• Collaborate with internal teams, providers, and external stakeholders to resolve issues and coordinate services.
• Respond to inquiries from clients, providers, and third parties regarding claims and payments.
• Maintain accurate records and documentation, and system updates for claims and authorize activities.
• Compile and report claim statistics and support monthly billing and reporting processes.
• Assist in developing procedures and guidelines to improve operational effectiveness.

Benefits

• Medical Coverage
• Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
• Paid time off, including vacation, personal, sick leave and 11 paid holidays per year
• Childbirth, Adoption, and Foster Care leave
• Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)
• Public Retirement Systems ( such as OPERS, STRS, SERS, and HPRS ) & Optional Deferred Compensation ( Ohio Deferred Compensation )

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 101-250 employees