Accountant/Examiner 3 (20014038)

The Bureau of HIV, STI, and Viral Hepatitis (BHSH) works to reduce the transmission of human immunodeficiency virus (HIV), sexually transmitted infections (STIs), and hepatitis B and C through surveillance, prevention, and care. The bureau also offers treatment through participating providers and services to eligible Ohioans living with HIV and STI.

What You'll Do:

We are currently seeking an Accountant/Examiner 3 to join our team. In this vital role, you'll analyze operations, systems, and procedures to improve the efficiency and cost-effectiveness of the statewide Ohio HIV Drug Assistance Program (OHDAP) and the Health Insurance Premium Payment (HIPP) program which provide services to eligible clients under the Ryan White Part B program. To learn more about these programs CLICK HERE.

• Analyze health insurance plans (e.g., Affordable Care Act [ACA] Marketplace) to assess cost-effectiveness, provider coverage, and approved formulary anti-retroviral therapies.
• Review explanation of payments (EOP) and explanation of benefits (EOB) to determine accuracy and sources of payments for health insurance premiums and co-pays.
• Examine the Ryan White program provider list and compare the essential community provider list to ensure inclusion so that providers with experience caring for medically underserved populations are represented.
• Access federal database to review, verify &/or revise provider tax identification numbers and send resolutions for discrepancies to the Third-Party Administrator.
• Gather and analyze information about alternative private health insurance coverage (e.g., HMO, Medicare, off-market plans) and make recommendations for additional kinds of program assistance when it is likely to be cost-effective.
• Monitor coordination of benefits (COB) and propose recommendations for improving program case processing and automated cost-avoidance systems designed to assure that insurance benefits are applied appropriately to the costs of medical services authorized by program (e.g., when program has paid a premium payment, verification of co-pay has been billed versus full pay, ensuring accurate service codes and backbilling other payer sources).
• Use the Ryan White Application Database & Third Party Administrator portal to determine, designate, and monitor Ryan White Part B participant's eligibility for insurance benefits.
• Maintain and develop tracking systems, spreadsheets, and databases for implementing, monitoring, reporting, and evaluating program premiums assistance.
• Compose letters and forms for communication with program participants, provider insurance companies, and government agencies.
• Applications of those who meet the minimum qualifications will be further evaluated against the following criteria:
• Undergraduate degree in accounting, finance, business administration, economics, computer science or related field
• Experience in analyzing health insurance plans (cost-effective/formulary covers antiretrovirals)
• Experience in health insurance claims (e.g., billing, review)
• Experience working with a third-party payer and coordinating benefits
• Experience working with health insurance providers, case managers, or clients to resolve insurance premium payment or co-pay issues.
• Experience working with spread sheet software (e.g., Excel)
• Experience preparing written summaries of findings on health insurance plans cost effectiveness

All eligible applications shall be reviewed considering the following criteria: qualifications, experience, education, and active disciplinary record.

12 months experience as Accountant/ Examiner 2, 66112 with state government experience commensurate with duties to be assigned.

OR

Completion of undergraduate core coursework in accounting or 2 years experience in accounting.

OR

Completion of undergraduate core coursework in business administration, economics, computer science or related field; AND 16 semester or 24 quarter hours in accounting.

Or equivalent of Minimum Class Qualifications for Employment noted above.

Job Skills: Accounting and Finance

Technical Skills: Operational and Administrative support, Accounting and Finance

Professional Skills: Critical Thinking, Attention to Detail, Verbal and Written Communication, Establishing Relationships

Educational Transcript Requirements: Official educational transcripts are required for all post-high school educational accomplishments, coursework or degrees claimed on the application. Applicants will be required to submit an official transcript prior to receiving a formal offer of employment. Failure to provide transcripts within five (5) working days of being requested will cause the applicant to be eliminated from further consideration.

Please note that a transcript is considered "official" only if it is an original copy from the educational institution and includes an institutional watermark, ink stamp or embossed stamp. Transcripts printed from the institution's website will not be accepted. ODH reserves the right to assess the academic credibility of an educational entity's award of a putative degree