Medical Assistance Specialist 4 (MAS4/AHSO) – Internal

Medical Assistance Specialist 4 – Internal

This is a full-time permanent, remote position. Employees may occasionally be asked to attend an in-person meeting or event based on business needs.

This is an internal opportunity and is only open to current HCA employees.

All HCA employees are required to be Washington state residents upon their first day of employment.

The Opportunity

Lead a team of medical assistance specialist 3s in the dental authorization unit, including training staff, performing quality control, and updating policies and manuals. This lead position helps staff with complex situations and also has the opportunity to back-up the team’s supervisor when needed.

Key Responsibilities

• Independently train and lead staff in determining client eligibility.
• Ensure accuracy and the smooth and timely response to requests by MAS3's.
• Review claims in relation to claim rejection and analyze problems.
• Advise providers and generate client notification of decision outcomes.
• Respond to complex staff questions and research to find answers.
• Answer internal and external e-mails and phone calls from supervisors, systems staff, unit staff, and other departments.
• Develop training materials for staff in Excel, PowerPoint, and Word.
• Train new staff and existing staff on upcoming initiatives and system changes.
• Lead MAS meetings to go over process changes and general questions from staff.
• Periodically silent monitor staff calls for quality customer service and follow up with staff on training needs.
• Participate in continual process improvement endeavors and revise prior authorization processes and procedures, database modifications/maintenance, and forms development.

What You Bring

• Policy knowledge: You have an advanced knowledge of program policies to be able to communicate them with providers.
• Customer service excellence: You have demonstrated proficiency in customer service across your career.
• Collaborative: You work well with colleagues on various levels of an organization and understand when to consult with others.

Required Qualifications

Experience may have been gained through paid or unpaid activities. Please ensure any relevant experience defined below is outlined in your cover letter, resume, and application.

• Competency in participating in continuous process improvement endeavors, including revising prior authorization (PA) processes, modifying databases, and developing forms.
• Skill in consulting with Unit Supervisors and Operations Managers regarding policy updates, system changes, complex billings, and workload bandwidth.
• Ability to clarify intricate program policies, criteria, and provider billing instructions to various healthcare provider types.
• Providing high-level consultative services over toll-free lines and handling internal/external communications with a positive, cooperative, and professional attitude.
• Ability to independently train, onboard, and provide refresher training to new and existing staff on systems, upcoming initiatives, and program changes.
• Competency in developing comprehensive training materials utilizing MS Office tools (Excel, PowerPoint, Word).
• Capability to periodically conduct silent call monitoring to ensure high-quality customer service and follow up on identified training gaps.
• Skill in keeping the team focused, supporting and encouraging peers, and publicly acknowledging both small and big team accomplishments.
• Ability to ensure accuracy and timely responses to requests by efficiently delegating and monitoring the daily workflow of staff.
• Ability to independently and professionally handle internal team issues, staff inquiries, and complex customer complaints.
• Extensive, up-to-date knowledge of the Washington Administrative Code (WAC) guidelines, HCA Provider Guides, and numbered memorandums to ensure legally compliant processing timelines.
• Advanced proficiency in reviewing and researching complex procedure codes and diagnosis codes to determine if authorization requests are complete and valid.
• Ability to review and analyze complex billings, claim rejections, denials, credits, and replaced claims to identify root causes and resolve issues.
• Expertise in verifying client eligibility specifically within the Dental-Related Services package and managing multiple state program requirements.
• Technical capability to build authorization screens, track workload inventory, and coordinate with other divisions regarding complex back-end details like pricing.
• Responsibility for maintaining, updating, and navigating the internal Dental SharePoint repository.
• Advanced daily utilization of MS Word, Excel, Outlook, PowerPoint, Access, RightFax, and custom dental databases.
• Competency in generating legally compliant, clear, and concise client/provider decision outcome notifications.
• Skill in working harmoniously with other divisions, systems staff, and external departments to streamline multi-program requirements.

Required Competencies

• Equity lens – All HCA employees are required to consider equity in their decisions, processes, and day-to-day work, including how their work may affect the people and communities we serve.
• The ability to take action to learn and grow – You take action to learn and grow by seeking new perspectives, learning from experiences, and using what you’ve learned to continuously improve how you work and serve others.
• The ability to take action to meet the needs of others – You take action to meet the needs of others by listening, understanding different perspectives, and responding with care, respect, and solutions that support the people of the communities we serve.

Preferred Qualifications

While these are not required, having them may help you stand out as an applicant.

One of the following criteria combinations

• Bachelor’s degree AND two years of experience providing direct client services or counseling of customers in a dental office setting, 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; including two years of experience working in a dental office setting, to include a working knowledge of health insurance, claims, or other related health benefits.
• Associate degree AND four years of experience as described above.
• Six years of experience as described above.
• One year as a Medical Assistance Specialist 3

About the Washington State Health Care Authority

Better Health. Better Care. A Healthier Washington.

At HCA, we work to ensure people across Washington have the opportunity to be as healthy as possible. As the State’s largest health care purchaser and behavioral health authority, HCA serves nearly 3 million Washington residents through Apple Health (Medicaid), Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs, and behavioral health services. Through this work, HCA purchases and coordinates care coverage, supports behavioral health prevention, treatment, crisis response, and recovery and helps strengthen access to high-quality care across Washington.

More than a benefits package

• We want our employees to have the support, flexibility, and benefits they need to do their best work and build a career that works for their life.
• As a Washington State HCA employee, you’ll have access to a comprehensive benefits package that supports your health, financial well-being, and work-life balance.
• Our benefits are designed to support you today while helping you plan for the future.
• Learn more about why HCA by visiting the Voices of HCA and the "Who we are" section of our website.

Your total compensation is more than your paycheck

• Remote work and flexible schedules
• Medical, dental, vision, and basic life insurance
• Paid vacation, sick leave, and 12 paid holidays
• Paid Family and Medical Leave (PFML)
• Retirement options to plan for the future
• Training and professional development opportunities
• Employee wellness programs
• Learn more about Washington State Employee Benefits

Work Location and Schedule

• This is a full-time 40-hour-per-week remote position.
• Our standard business hours are Monday through Friday, 8 a.m. to 5 p.m., with alternative work schedules considered based on business needs and supervisor approval.
• In this role you will regularly collaborate with colleagues, agency leaders, state and federal partners, and other external partners or customers.
• Occasional travel may be required for meetings, training, or other business needs.
• All employees are required to report to our Olympia office on their first and final day of employment.

Our commitment to an inclusive workplace

Our commitment to inclusion is reflected in how we work together and serve the people of Washington. HCA also supports five voluntary employee led Employee Resource Groups (ERGs), which create opportunities for connection, community, learning, and professional growth.

Application Directions

• To be considered, you must complete the online application in full and submit all required materials.
• Incomplete applications or applications missing required materials will not be considered.
• When completing your application, please include the following required materials:

• Cover letter: describing your qualifications for this specific position
• Resume: that details your applicable experience and education.
• Three (3) professional references: References must be entered directly into the designated references section of your application. We require 3 professional references including at least one current or recent supervisor.

• We encourage you to apply!
• If you meet the required qualifications for this position; we want to hear from you.
• Desired qualifications describe additional experience, knowledge or skills that may be helpful in the role, but they are not required to be considered for the position.
• We welcome applicants with different backgrounds, experiences, identities, and perspectives.

• Veterans: We value the experience and skill veterans bring to the workforce and encourage veterans, transitioning service members, and military spouses to apply.
• Eligible veterans may qualify for veterans’ preference in accordance with Washington State Law.
• If you are claiming veterans’ preference, you must attach your applicable DD-214 documentation to your application.
• Please redact your social security number, date of birth, and any other sensitive information before uploading and attaching the document.

Need accommodations or have questions? If you have questions, need assistance with the application process, require an accommodation, or would like to request this posting in an alternative format, please contact Jake Nelko, human resources consultant – recruiter, at and reference the recruitment title and job number in the subject line.

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