HEALTH OMBUDSMAN (ADMINISTRATIVE OFFICER III)

Introduction

The Attorney General is the chief legal\r\nofficer of the State of Maryland. The Office of the Attorney General (OAG) has\r\nthe general charge, supervision, and direction of the State’s legal business,\r\nacting as legal advisors and representatives of the major agencies, various\r\nboards, commissions, officials, and institutions of State Government. The OAG\r\nalso protects the public by civil enforcement of antitrust, civil rights,\r\nconsumer protection, and securities laws and regulations and by the prosecution\r\nof organized crime, Medicaid fraud, environmental crimes, insurance fraud,\r\nstate tax evasion, and other statutorily assigned matters. As Maryland’s 47th\r\nAttorney General, Anthony G. Brown leads the Office with a critical focus on\r\nequity, justice, and fairness.\r\n

GRADE

15\r\n\r\n\r\nThis position offers a salary range of $62,220 - $87,661, with potential for advancement up to $96,790 based on qualifications, equity, and hiring guidelines. Initial salary offers are determined by qualifications, experience, and available budget, and typically do not exceed $87,661.\r\n

LOCATION OF POSITION

200 St. Paul Place\r\nBaltimore, MD 21202\r\n

Main Purpose of Job

\r\nThe Consumer\r\nProtection Division�Health Education and Advocacy Unit\r\n(HEAU) is�seeking�a dedicated and compassionate individual to join\r\nour team as an Ombudsman.��HEAU plays�a vital role in protecting\r\nand empowering Maryland consumers by:\r\n\r\n�\r\nAssisting�individuals\r\nin resolving billing disputes with health care providers and insurers.��\r\n�\r\nHelping\r\nconsumers navigate health insurance coverage denials and appeals.�\r\n�\r\nEducating\r\nthe public about their healthcare rights and responsibilities.��\r\n�\r\nAdvocating\r\nfair and�equitable�access to healthcare services.��\r\n\r\n\r\nThe\r\nUnit receives approximately 2,000 consumer complaints, 4,500 hotline calls,\r\nand 6,000 emails each year, reflecting the high volume and critical nature of\r\nour work.��The team is�comprised�of two attorneys, two case\r\nmanagers, an administrative assistant, and eight ombudsmen. We also work with a\r\ndedicated group of volunteers, interns, and law clerks who support our mission\r\nyear-round.�Join our team to help Marylanders resolve complex health care\r\nissues to ensure fair access to care for all.\r\n\r\n\r\n\r\n

POSITION DUTIES

\r\nKey Responsibilities:\r\n\r\n\r\n\r\n Review and analyze denied insurance claims to�determine�the basis for denial.��\r\n Assist�consumers in understanding their rights and�appeal options.� ��\r\n Prepare and�submit�written appeals with supporting documentation.� �\r\n Assist�consumers with�a range of�healthcare-related concerns, including�billing�disputes; financial�assistance; and coverage�issues.​��\r\n Communicate with insurance companies, healthcare providers, and patients to gather necessary information.\r\n Track�all complaint and�appeal statuses�and ensure�timely�follow-up.� ��\r\n Maintain�accurate�records of all�complaints and correspondence.� ��\r\n Stay current with healthcare regulations, payer policies, and appeal procedures.� ��\r\n Educate consumers on the appeals process and advocate on their behalf.� ��\r\n Respond to inquiries via the HEAU hotline.� ��\r\n Supervise and mentor volunteers and interns�assisting�with complaint resolution.� �\r\n\r\n\r\n\r\n\r\nThis role involves frequent interaction by phone and in writing with consumers, providers, and insurers.�It’s�an opportunity to help people resolve real-world problems and protect Maryland’s most vulnerable residents from unfair and deceptive practices.\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n

MINIMUM QUALIFICATIONS

\r\n\r\nEducation: Graduation from an accredited high school or possession of a high school equivalency certificate.\r\n\r\n\r\nExperience: Three years of administrative or professional work.���\r\n\r\n\r\nStrong written and verbal communication skills, excellent organizational and time management abilities, proficiency in Microsoft Office and database software, knowledge of HIPAA and healthcare privacy regulations and empathy and patience when working with consumers under stress.�\r\n\r\n\r\nNotes:�\r\n1. Candidates may substitute 30 college credit hours from an accredited college or university for each year up to two years of the required experience. �\r\n2. Candidates may substitute the possession of a Bachelor's degree from a college or university for the required experience.�\r\n3. Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer.\r\n\r\n\r\n\r\n\r\n\r\n\r\n

DESIRED OR PREFERRED QUALIFICATIONS

Preferred Qualifications:\r\n\r\n\r\n\r\n\r\n Bachelor’s degree in nursing, healthcare administration, public health, social work, or a related field or associate’s degree with relevant experience.�\r\n 2+ years of experience in health law, health insurance, medical billing, claims processing, or patient advocacy.\r\n Familiarity with insurance denial codes, appeal processes, and payer-specific guidelines.��\r\n Experience working in a healthcare setting, nonprofit, or consumer advocacy organization.\r\n Leading teams in supervisory roles.�\r\n\r\n\r\n

LICENSES, REGISTRATIONS AND CERTIFICATIONS

Employees in this classification may be assigned duties which require the operation of a motor vehicle. Employees assigned such duties will be required to possess a motor vehicle operator’s license valid in the State of Maryland.\r\n

SELECTION PROCESS

Applicants who meet the minimum and selective qualifications will be included in further evaluation. The evaluation may be a rating of your application based on your education, training and experience as they relate to the requirements of the position. Therefore, it is essential that you provide complete and accurate information on your application and answer all supplemental questions. Please report all related education, experience, dates and hours of work. Clearly indicate your college degree and major on your application, if applicable. For education obtained outside the U.S., any job offer will be contingent on the candidate providing an evaluation for equivalency by a foreign credential evaluation service prior to starting employment (and may be requested prior to interview).\r\n\r\n\r\nComplete applications must be submitted by the closing date. Information submitted after this date will not be added. Incorrect/incomplete application forms will not be accepted. Please include complete dates of service, job title, and job duties. Resumes will not be accepted in lieu of a completed application.\r\n\r\n\r\nSuccessful candidates will be placed on the eligible list for at least one year.� Candidates may remain on the certified eligible list for a period of at least one year. The resulting certified eligible list for this recruitment may be used for similar positions in this or other State agencies.\r\n

BENEFITS

STATE OF MARYLAND BENEFITS\r\n\r\n\r\nThe successful candidate will be eligible for subsidized health benefits (medical, prescription, dental and vision coverage) and life insurance; leave, including annual (vacation), personal, sick, and paid parental leave; and will be eligible for participation in a contributory defined benefit pension plan in which they are vested after ten years. State employees are eligible to participate in two supplemental retirement plans: the 457 Deferred Compensation Plan and the 401(k) Savings and Investment Plan. The State also offers a free mass transit benefit for local bus and express bus services.\r\n

FURTHER INSTRUCTIONS

\r\n\r\nOnline applications are STRONGLY preferred. Please upload a resume in addition to the on-line application. If the online application process is not available, please send your paper application and supplemental questionnaire to careers@oag.maryland.gov or fax to 443-681-1062.� �TTY Users: call via Maryland Relay.\r\n\r\n\r\nIf you have specific questions about recruitment, email careers@oag.maryland.gov�\r\n\r\n\r\nThe Office of the Attorney General is an equal opportunity employer that encourages all interested persons to apply regardless of race, color, religion or belief, ancestry, national origin, age, marital status, sexual orientation, gender identity and/or expression, disability, pregnancy, family or parental status, veteran status, genetic information, or any protected category prohibited by local, State or federal laws.\r\n\r\n\r\n\r\n\r\n