• Job Description

  Req#: 5456239
  Salary: $48,048.00 - $64,512.00 Annually
  Location : Thurston County - Olympia, WA
  Job Type: Full Time - Permanent
  Remote Employment: Remote Optional
  Job Number: 2026-07009
  Department: Health Care Authority
  Division: AHSO
  Opening Date: 08/20/2026
  Closing Date: 8/27/2026 11:59 PM Pacific
  Salary Information: The high end of the salary range, Step M is typically a longevity step
  
  Description
  COBCO Health Insurance Specialist (MAS3/AHSO)
  
  71029258
  
  This position investigates and researches cases of Medicaid billing to determine whether third party liability coverage should have been used. The goal of this work is to ensure that Medicaid has been the payer of last resort, to ensure proper use of these public funds. This work requires delving into situations to find new information and wade through ambiguity with a goal of ensuring medical costs being covered by the correct entities. If you are a problem solver who likes to ask questions and dig deep to uncover issues or explore curiosities, this may be the position for you!
  
  All HCA employees will apply an equity lens to their work, which may include but is not limited to all analyses of core business and processes.
  
  About the division:
  
  The organization's mission is to provide high quality health care through innovative health policies and purchasing strategies. The Apple Health Services and Operations (AHSO) Division works across the Health Care Authority (HCA) and in partnership with the health care community at local, state and federal levels, in order to develop, and manage high quality, and evidence-based health care programs and purchase services that enhance Washington State's citizens' ability to access appropriate, quality health care.
  
  About the position:
  
  This position resides in the Health Insurance Unit (HIU) within the Coordination of Benefits and Claims Office (COBCO) and supports HCA's vision for a healthier Washington via both health purchasing strategies as well as customer-centered service. This position investigates and verifies potential third party liability (TPL) coverage leads and integrates third party liability coverage into the ProviderOne MMIS, to ensure cost avoidance or cost recovery of Medicaid expenditures, assuring Medicaid will be the payer of last resort. TPL refers to the legal obligation of third-party health care sources to pay for a claim for a Medicaid client before Medicaid pays the claim. In this position, staff independently provide expert consultative services to providers and clients, both orally and in writing, concerning coordination of TPL and Medicaid benefits.
  
  This position is eligible to telework and is typically not required to report on-site.The default assigned work location of all Health Care Authority (HCA) positions - both on-site and telework eligible positions - is within the State of Washington. This position reports to Olympia, WA. Frequency of onsite work will vary based on business and operational needs. All agency employees are required to report on-site in Olympia on their first and last days of employment to pick up and return state-issued equipment, regardless of telework status or location.
  
  Duties
  Some of what you will do:
  
  • Makes complex judgments and payment determinations in accordance with state and federal law and regulations and HCA policy.
  • Investigates and analyzes insurance documents, reports, files, and other resources to determine private health insurance benefits and eligibility.
  • Accesses ProviderOne subsystems, and updates and maintains control files used to adjudicate claims and determine Managed Care enrollment eligibility.
  • Recovers funds from insurers when a private health insurer is liable for costs incurred by a Medicaid eligible individual.
  • Resolves complex complaints and issues relating to Coordination of Benefits health insurance for clients, providers, and insurance companies.
  • Independently examines correspondence from health insurance carriers and determines appropriate action.
  • Investigates recipient employment and health insurance benefits using the Automated Client Eligibility System (ACES) & Document Management System (DMS / BARCODE).
  • Provides expert consultative services relating to coordination of health insurance benefits to clients, providers and other internal and external customers.
  • Reviews, investigates and responds to inquiries.
  • Participates in collaborative conversations to share information related to the health insurance unit and the general needs of the Coordination of Benefits and Claims Office.
  
  Qualifications
  Required qualifications:
  
  Qualifying candidates will meet one of the following criteria options:
  
  Option 1:
  
  • Bachelor's degree and
  • One year of the experience defined below.
  
  Option 2:
  
  • Associate degree and
  • Three years of the experience defined below.
  
  Option 3:
  
  • Certificate of Medical Billing and Coding, or a closely related certificate program, and
  • Three years of the experience defined below.
  
  Option 4:
  
  • Five years of the experience defined below.
  
  Option 5:
  
  • One year as a Medical Assistance Specialist 2.
  
  Qualifying experience is defined as:
  
  • providing direct client services or counseling of customers in the areas of health insurance, disability, or other related health benefits;
  • public assistance eligibility determination;
  • health insurance premiums/claims processing, adjusting, and investigation;
  • other medical premiums/claims/eligibility related experience; or
  • experience researching and analyzing complex rules, regulations, or policies and utilizing research and analysis to make determinations, solve problems, or complete work while providing direct customer service either in person or on the telephone.
  
  Required competencies:
  
  • The ability to take action to learn and grow.
  • The ability to take action to meet the needs of others.
  
  Preferred qualifications:
  
  Demonstrated experience with:
  
  • Communicating with external parties to acquire or understand complex information
  • Navigating web sites and online resources to perform research and make decisions
  • Writing correspondence on complex topics in a way that makes concepts clear to the recipient
  • Navigating complex problems for which there may be incomplete information or context
  • Medicaid and/or private health insurance
  • ProviderOne, Barcode, Service Now (SNOW), and ACES Online
  • Microsoft products (Outlook, OneNote, Excel, Teams, Word, etc)
  • Strong oral and written communication skills while providing excellent customer service
  • Resolving complex complaints, problems, and conflicts with clients, providers and insurance companies
  • Critical thinking skills; use good judgment in evaluating situations and making decisions
  • Self-motivation and working independently
  
  Knowledge of:
  
  • Medical terminology, anatomy, procedure and diagnosis codes
  • Medical billing and insurance claim processes
  
  Demonstrated ability to:
  
  • Understand and apply procedures, policies, and guidelines
  • Learn new and/or increasingly complex duties
  • Accept accountability for actions; use feedback to improve
  • Navigate comfortably when using technology (Outlook, Word, Excel, web navigation)
  
  How to apply:
  
  Only candidates who reflect the minimum qualifications on their NEOGOV profile will be considered. Failure to follow the application instructions below may lead to disqualification. To apply for this position, you will need to complete your profile which includes three professional references and attach in separate files:
  
  • A cover letter that specifically addresses how you meet the qualifications for this position
  • Current resume
  
  To take advantage of veteran preference, please do the following:
  
  • Attach a copy of your DD214 (Member 4 long-form copy), NGB 22, or USDVA signed verification of service letter.
  • Please black out any PII (personally identifiable information) data such as social security numbers. Include your name as it appears on your application in careers.wa.gov.
  
  Supplemental Information
  About HCA:
  
  Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.
  
  There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.
  
  What we have to offer:
  
  • Meaningful work with friendly co-workers who care about those we serve
  • A clear agency mission that drives our work and is person-centered
  • A healthy work/life balance, including alternative/flexible schedules and mobile work options.
  • A great total compensation and benefit package
  • A safe, pleasant workplace in a convenient location with restaurants, and shopping nearby.
  • And free parking!
  
  Notes:
  
  This position is covered by the Washington Federation of State Employees (WFSE). Once the listed position(s) is(are) filled, this recruitment announcement may also be used to fill additional position(s) for up to sixty (60) days.
  
  Prior to a new hire, a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment.
  
  HCA is an equal opportunity employer. We value the importance of creating an environment in which all employees can feel respected, included, and empowered to bring unique ideas to the agency. HCA has five employee resource groups (ERGs). ERGs are voluntary, employee-led groups whose aim is to foster a diverse, inclusive workplace aligned with HCA's mission. Our diversity and inclusion efforts include embracing different cultures, backgrounds and viewpoints while fostering growth and advancement in the workplace. Studies have shown women, racial and ethnic minorities, and persons of disability are less likely to apply for jobs unless they feel they meet every qualification as described in a job description. Persons over 40 years of age, disabled and Vietnam era veterans, as well as people of all sexual orientations and gender identities are also encouraged to apply. If you have any questions about the required qualifications or how your experience relates to them, please contact us at Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Jake Nelko at 360-725-0945 or
  
  The Washington State Health Care Authority (HCA) is an All applicants with a in the United States are encouraged to apply.
  E-Verify® is a registered trademark of the U.S. Department of Homeland Security.
  to receive a list of new job postings at HCA.
  More than Just a Paycheck!
  Employee benefits are not just about the kind of services you get, they are also about how much you may have to pay out of pocket. Washington State offers one of the most competitive benefits packages in the nation.
  
  We understand that your life revolves around more than just your career. Like everyone, your first priority is ensuring that you and your family will maintain health and financial security. That's why choice is a key component of our benefits package. We have a selection of health and retirement plans, paid leave, staff training and other compensation benefits that you can mix and match to meet your current and future needs.
  
  Read about our benefits:
  The following information describes typical benefits available for full-time employees who are expected to work more than six months. Actual benefits may vary by appointment type or be prorated for other than full-time work (e.g. part-time); view the job posting for benefits details for job types other than full-time.
  
  Note: If the position offers benefits which differ from the following, the job posting should include the specific benefits.
  
  Insurance Benefits
  Employees and their families are covered by medical (including vision), dental and basic life insurance. There are multiple medical plans with affordable monthly premiums that offer coverage throughout the state.
  
  Staff are eligible to enroll each year in a medical flexible spending account which enables them to use tax-deferred dollars toward their health care expenses. Employees are also covered by basic life and long-term disability insurance, with the option to purchase additional coverage amounts.
  
  To view premium rates, coverage choice in your area and how to enroll, please visit the Public Employees Benefits Board (PEBB) website. The Washington Wellness program from the Health Care Authority works with PEBB to support our workplace wellness programs.
  
  Dependent care assistance allows the employee to save pre-tax dollars for a child or elder care expenses.
  
  Other insurance coverage for auto, boat, home, and renter insurance is available through payroll deduction.
  
  The Washington State Employee Assistance Program promotes the health and well-being of employees.
  
  Retirement and Deferred Compensation
  State Employees are members of the Washington Public Employees' Retirement System (PERS). New employees have the option of two employer contributed retirement programs. For additional information, check out the Department of Retirement Systems' web site.
  
  Employees also have the ability to participate in the Deferred Compensation Program (DCP). This is a supplemental retirement savings program (similar to an IRA) that allows you control over the amount of pre-tax salary dollars you defer as well as the flexibility to choose between multiple investment options.
  
  Social Security
  All state employees are covered by the federal Social Security and Medicare systems. The state and the employee pay an equal amount into the system.
  
  Public Service Loan Forgiveness
  If you are employed by a government or not-for-profit organization, and meet the qualifying criteria, you may be eligible to receive student loan forgiveness under the Public Service Loan Forgiveness Program.
  
  Holidays
  Full-time and part-time employees are entitled to paid holidays and one paid personal holiday per calendar year.
  
  Note: Employees who are members of certain Unions may be entitled to additional personal leave day(s), please refer to position specific Collective Bargaining Agreements for more information.
  
  Full-time employees who work full monthly schedules qualify for holiday compensation if they are employed before the holiday and are in pay status for at least 80 nonovertime hours during the month of the holiday; or for the entire work shift preceding the holiday.
  
  Part-time employees who are in pay status during the month of the holiday qualify for the holiday on a pro-rata basis. Compensation for holidays (including personal holiday) will be proportionate to the number of hours in pay status in the month to that required for full-time employment, excluding all holiday hours. Pay status includes hours worked and time on paid leave.
  
  Sick Leave
  Full-time employees earn eight hours of sick leave per month. Overtime eligible employees who are in pay status for less than 80 hours per month, earn a monthly proportionate to the number of hours in pay status, in the month to that required for full-time employment. Overtime exempt employees who are in pay status for less than 80 hours per month do not earn a monthly accrual of sick leave.
  
  Sick leave accruals for part-time employees will be proportionate to the number of hours in pay status, in the month to that required for full-time employment. Pay status includes hours worked, time on paid leave and paid holiday.
  
  Vacation (Annual Leave)
  Full-time employees accrue vacation leave at the rates specified in (1) or the applicable collective bargaining agreement (CBA). Full-time employees who are in pay status for less than 80 nonovertime hours in a month do not earn a monthly accrual of vacation leave.
  
  Part-time employees accrue vacation leave hours in accordance with (1) or the applicable collective bargaining agreement (CBA) on a pro rata basis. Vacation leave accrual will be proportionate to the number of hours in pay status, in the month to that required for full-time employment.
  
  Pay status includes hours worked, time on paid leave and paid holiday.
  
  As provided in , an employer may authorize a lump-sum accrual of vacation leave or accelerate the vacation leave accrual rate to support the recruitment and/or retention of a candidate or employee for a Washington Management Service position. Vacation leave accrual rates may only be accelerated using the rates established WAC 357-31-165.
  
  Note: Most agencies follow the civil service rules covering leave and holidays for exempt employees even though there is no requirement for them to do so. However, agencies are required to adhere to the applicable RCWs pertaining holidays and leave.
  
  Military Leave
  Washington State supports members of the armed forces with 21 days paid military leave per year.
  
  Bereavement Leave
  Most employees whose family member or household member dies, or for loss of pregnancy, are entitled to five (5) days of paid bereavement leave. In addition, the employer may approve other available leave types for the purpose of bereavement leave.
  
  Additional Leave
  Leave Sharing
  
  Family and Medical Leave Act (FMLA)
  Leave Without Pay
  
  Please visit the State HR Website for more detailed information regarding benefits.
  
  Updated 01-07-2026
  01
  
  Please select the highest level of education that you have completed:
  • High school graduation or equivalent
  • Associate degree, Certificate of Medical Billing and Coding, or a closely related certificate program
  • Bachelor's degree
  • Master's degree or higher
  • None of the above
  
  02
  
  Which of the following best describes your professional work experience in any or a combination of the following?:• Providing direct client services or counseling of customers in the areas of health insurance, disability, or other related health benefits.• Public assistance eligibility determination.• Health insurance premiums/claims processing, adjusting, and investigation.• Other medical premiums/claims/eligibility related experience.• Experience researching and analyzing complex rules, regulations, or policies and utilizing research and analysis to make determinations, solve problems, or complete work while providing direct customer service either in person or on the telephone.
  • I do not have this experience
  • Less than 1 year
  • More than 1 year, but less than 3 years
  • More than 3 years, but less than 5 years
  • More than 5 years
  
  03
  
  If you indicated you have the experience noted in the above question, please explain how, where, and when you gained this knowledge and experience (must be reflected in the work experience of your application). Do not state "see resume" or copy and paste that material. If you answered no, please type N/A in the text box below.
  04
  
  Do you have the ability to take action to learn and grow?
  • Yes
  • No
  
  05
  
  Do you have the ability to take action to meet the needs of others?
  • Yes
  • No
  
  06
  
  Which of the following best describes your professional work experience communicating with external parties to acquire or understand complex information?
  • I do not have this experience.
  • Less than 1 year
  • More than 1 year, but less than 2 years
  • More than 2 years, but less than 3 years
  • More than 3 years, but less than 4 years
  • More than 4 years, but less than 5 years
  • More than 5 years
  
  07
  
  Which of the following best describes your professional work experience navigating web sites and online resources to perform research and make decisions?
  • I do not have this experience.
  • Less than 1 year
  • More than 1 year, but less than 2 years
  • More than 2 years, but less than 3 years
  • More than 3 years, but less than 4 years
  • More than 4 years, but less than 5 years
  • More than 5 years
  
  08
  
  Which of the following best describes your professional work experience writing correspondence on complex topics in a way that makes concepts clear to the recipient?
  • I do not have this experience.
  • Less than 1 year
  • More than 1 year, but less than 2 years
  • More than 2 years, but less than 3 years
  • More than 3 years, but less than 4 years
  • More than 4 years, but less than 5 years
  • More than 5 years
  
  09
  
  Which of the following best describes your professional experience navigating complex problems for which there may be incomplete information or context?
  • I do not have this experience.
  • Less than 1 year
  • More than 1 year, but less than 2 years
  • More than 2 years, but less than 3 years
  • More than 3 years, but less than 4 years
  • More than 4 years, but less than 5 years
  • More than 5 years
  
  10
  
  Which of the following best describes your professional experience with Medicaid and/or private health insurance?
  • I do not have this experience.
  • Less than 1 year
  • More than 1 year, but less than 2 years
  • More than 2 years, but less than 3 years
  • More than 3 years, but less than 4 years
  • More than 4 years, but less than 5 years
  • More than 5 years
  
  11
  
  Which of the following best describes your professional experience with ProviderOne?
  • I do not have this experience
  • Less than 1 year
  • More than 1 year, but less than 2 years
  • More than 2 years, but less than 3 years
  • More than 3 years, but less than 4 years
  • More than 4 years, but less than 5 years
  • More than 5 years
  
  12
  
  Which one of the following best describes your skills with Microsoft Teams?
  • Novice
  • Intermediate
  • Proficient
  • Expert
  
  13
  
  Which one of the following best describes your skills with Microsoft OneNote?
  • Novice
  • Intermediate
  • Proficient
  • Expert
  
  14
  
  Which one of the following best describes your skills with Microsoft Outlook?
  • Novice
  • Intermediate
  • Proficient
  • Expert
  
  15
  
  If hired for this position, do you currently possess required documents to allow you to legally work within the United States? The attached link lists acceptable documents: https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents
  • Yes
  • No
  
  16
  
  Will you require sponsorship for an employment-related immigration benefit, either now or in the future?
  • Yes
  • No
  
  17
  
  I acknowledge that I have included at least three references, and that I have uploaded a cover letter and resume in the attachments section of my application.
  • Yes
  • No
  
  Required Question

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