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State of Montana Program Integrity Compliance Specialist (08150) in Helena, Montana

The Montana Department of Public Health and Human Services (DPHHS) has an exciting opportunity within the Office of Inspector General, Program Compliance. Our mission at DPHHS is to improve and protect the health, well-being, and self-reliance of all Montanans throughout every stage of their life. By joining our team, you will have the opportunity to perform meaningful work in public service to our state and its residents. Whether you are joining the workforce or have several years of experience, DPHHS has the opportunity for you! This position identifies and investigates potential provider fraud, abuse and waste of Montana Medicaid and Healthy Montana Kids (HMK) programs. Duties include reviewing provider billing practices, as well as computer and information systems to investigate medical claims data and compliance with state and federal laws; analyzing data; interviewing providers; determining overpayments or underpayments, etc. This position may be eligible for partial telework within the state of Montana. Specific conditions will be outlined as part of the job offer and must adhere to state policy. What We Can Offer You The State of Montana's comprehensive benefits package includes healthcare coverage, retirement plans, paid vacation, sick leave, and holidays, work/life balance, and eligibility to participate in the Public Service Loan Forgiveness program. Visit the Health Care and Benefits Division for more information at In addition to employee benefits, there are a wide range of advancement opportunities within the largest state agency in Montana. What You Can Offer Us * Strong knowledge of fiscal and program management principles. * Strong knowledge of the long-term care services and supports delivery and applicable reimbursement systems. * Strong skills in planning, organization, conflict resolution, and oral and written communication. * Ability to establish open working relationships with employees, colleagues, federal officers, contractors, other agencies, and the public. * Meet minimum qualifications: o Bachelor’s degree in health sciences, health information, accounting, business, or social sciences related field. o Two years’ experience with medical claims, medical coding, or medical review of services. o Other combinations of related education and experience may be considered on a case-by-case basis. o Preferred coding certification through American Health Information Management Association (AHIMA) or American Academy of Professional Coder (AAPC). For a copy of the full job description or if you need a reasonable accommodation in the application or hiring process, contactShandee How to Apply Submit the following required documents with your application on the State of Montana Careers website. When submitting the required documents, you must check the “relevant document” box to ensure your attachments are uploading correctly to the specific application for this position. * Resume * Cover Letter * Professional References * Supplemental Questions o As the first line of support for a company or division; how do you anticipate the needs of the management team? o What is the difference between organizing and planning? How do you use these methods? To be considered for any DPHHS position, applicants must complete and submit their application online, and upload any required documents. Successful applicants are required to successfully pass all DPHHS specific background check(s) relevant to each position. DPHHS is an equal opportunity employer. Women, minorities, and people with disabilities are encouraged to apply. Title: Program Integrity Compliance Specialist (08150) Location: Helena Requisition ID: 23140800