Medical Facility and Records Examiner

The Pennsylvania Department of Human Services (DHS) and the Pennsylvania Department of Labor & Industry (L&I)
Position Details
Opening Date: 
Wed, 12/13/2017
Closing Date: 
Sat, 12/30/2017
Salary & Benefits: 
$54,690/annually, with excellent benefits.
Key Duties & Responsibilities: 
You will compile medical records/documentation to prepare reports documenting noncompliance with Medical Assistance Program regulations and/or potential criminal misconduct on the part of Medical Assistance Program service providers and/or eligible medical assistance recipients, and recommend appropriate action (or referral to appropriate legal entity for action). You will analyze information, records, documents, and treatment plans to ensure admissions to facilities (nursing and convalescent homes, hospitals, clinics, etc.) are warranted, treatment is appropriate, and Medical Assistance Program is properly billed. You will review and evaluate medical information through telephone discussions with hospital staff in order to certify medical necessity, length of stay, and compensability of inpatient hospital or same-day surgery admissions.
Education, Knowledge, Skills & Abilities: 
Necessary Special Requirement: Possession of a current license to practice as a Registered Nurse issued by the Pennsylvania State Board of Nursing; or possession of a non-renewable temporary practice permit issued by the Pennsylvania State Board of Nursing. In order to be considered, applicants must be PA residents, and must meet the following minimum requirements: three years of professional experience in the field of medical assistance, health care services, or human services; OR an equivalent combination of experience and training in the field of medical assistance, health care services, or human services.
More Details: 
You must apply for these opportunities no later than December 30, 2017. When applying, you must indicate a willingness to accept employment in Dauphin County. Condition Of Employment: Employees possessing non-renewable temporary practice permits must obtain licensure as a Registered Nurse within the one-year period as defined by the Pennsylvania State Board of Nursing. You must list your Registered Nurse license number and expiration date on your application. Have application and testing questions? Please call the State Civil Service Commission at (717) 783-3058.
Contact Info
Contact Info: 
How to Apply: Apply online at Log in to the Online Services section of the homepage. Select View Open Announcements & Apply from the menu, and reference announcement #2016-023 for Medical Facility and Records Examiner to submit your application. No written test is required. Your score will be based on information reported on the application. You must provide complete and accurate information, or your score may be lower than deserved; application processing may be delayed; or diVeterans: 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 and opportunities for veterans, visit the veterans section of squalification may result. You may take the test once under this announcement.
Additional Application Info: 
Location of DHS Vacancies: Bureau of Program Integrity (two vacancies) Office of Medical Assistance Programs (five vacancies) Office of Mental Health and Substance Abuse Services (two vacancies) Location of L&I Vacancies: Olcam Building 1171 South Cameron Street Harrisburg, PA 17104