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Third Party Liability Specialist

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Third Party Liability Specialist

Salary

$51,971.00 - $79,062.00 Annually

Location

Dauphin County, PA

Job Type

Civil Service Permanent Full-Time

Job Number

CS-2025-38508-39680

Department

Department of Human Services

Division

HS Div Third Prty Liab

Opening Date

12/22/2025

Closing Date

1/5/2026 11:59 PM Eastern

Job Code

39680

Position Number

00044278

Union

FOP Lodge 92

Bargaining Unit

G4

Pay Group

ST06

Bureau / Division Code

00211793

Worksite Address

303 Walnut Street

Worksite Address

Commonwealth Tower, 7th Floor

City

Harrisburg, Pennsylvania

Zip Code

17101

Contact Name

Ricki Paden

Contact Email

[email protected]

Bureau / Division

Bureau of Program Integrity / Division of Third Party Liability/Trauma Code Tracking (TCT) Unit

+ Description

+ Benefits

+ Questions

THE POSITION

Begin an exciting and new career doing investigative and recovery work! The Department of Human Service is seeking a Third Party Liability Specialist to join our staff in the Bureau of Program Integrity. While working in the Division of Third Party Liability, you will help us recover medical assistance payments. If you are a motivated individual, apply today and become an integral member of our team!

DESCRIPTION OF WORK

In this position, you will work on the recovery of medical assistance expenditures that were incorrectly or provisionally paid on behalf of DHS recipients. Your work will involve reviewing documents from attorneys and insurance companies, researching possible sources for recovery of medical assistance funds, and notifying relevant parties of DHS interest. You will initiate requests for medical claims for review and follow-up to ensure payment of the claim. In this role, you will need to maintain a knowledge of laws and regulations in relation to medical assistance fund recovery. Additionally, you will communicate with legal authority to recover medical assistance funds.

Interested in learning more? Additional details regarding this position can be found in the position description (https://careers.employment.pa.gov/pd/PD\_NEOGOV.asp?p=00044278) .

Work Schedule and Additional Information:

+ Full-time employment

+ Work hours are 8:00 AM to 4:00 PM, Monday - Friday, with a 30-minute lunch.

+ Free parking!

+ Telework: You may have the opportunity to work from home (telework) part-time, up to 3 days per week. In order to telework, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. If you are unable to telework, you will have the option to report to the headquarters office in Harrisburg. The ability to telework is subject to change at any time. Additional details may be provided during the interview.

+ Salary: In some cases, the starting salary may be non-negotiable.

+ You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.

REQUIRED EXPERIENCE, TRAINING & ELIGIBILITY

QUALIFICATIONS

Minimum Experience and Training Requirements:

+ Four years of technical experience collecting, reviewing, or evaluating information for program eligibility or insurance limits of liability;or

+ A bachelor’s degree;or

+ An equivalent combination of experience and training.

+ Applicants will be considered to have met the educational requirements once they are within 3 months of graduating with a qualifying degree.

Other Requirements:

+ You must meet the PA residency requirement (https://www.employment.pa.gov/Additional%20Info/Pages/default.aspx) . For more information on ways to meet PA residency requirements, follow the link (https://www.employment.pa.gov/Additional%20Info/Pages/default.aspx) and click on Residency.

+ You must be able to perform essential job functions.

How to Apply:

+ Resumes, cover letters, and similar documents willnotbe reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education).

+ If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.

+ Your application must be submitted by the posting closing date. Late applications and other required materials will not be accepted.

+ Failure to comply with the above application requirements may eliminate you from consideration for this position.

Veterans:

+ Pennsylvania law (51 Pa. C.S. §7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to www.pa.gov/agencies/employment/how-to-apply.html and click on Veterans.

Telecommunications Relay Service (TRS):

+ 711 (hearing and speech disabilities or other individuals).

If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.

The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.

EXAMINATION INFORMATION

+ Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam).

+ Your score is based on the detailed information you provide on your application and in response to the supplemental questions.

+ Your score is valid for this specific posting only.

+ You must provide complete and accurate information or:

+ your score may be lower than deserved.

+ you may be disqualified.

+ You may only apply/testoncefor this posting.

+ Your results will be provided via email.

Learn more about our Total Rewards by watching this shortvideo (https://www.youtube.com/embed/HtcSRnndflc?rel=0) !

See the total value of your benefits package by exploring ourbenefits calculator.

Health & Wellness

We offer multiple health plans so our employees can choose what works best for themselves and their families. Our comprehensive benefits package includes health coverage, vision, dental, and wellness programs.*

Compensation & Financial Planning

We invest in our employees by providing competitive wages and encouraging financial wellness by offering multiple ways to save money and ensure peace of mind including multiple retirement and investment plan options.

Work/Life Balance

We know there’s more to life than just work! Our generous paid leave benefits include paid vacation, paid sick leave, eight weeks of paid parental leave, military leave, and paid time off for most major U.S. holidays, as well as flexible work schedules and work-from-home opportunities.*

Values and Culture

We believe in the work we do and provide continual opportunities for our employees to grow and contribute to the greater good. As one of the largest employers in the state, we provide opportunities for internal mobility, professional development, and the opportunity to give back by participating in workplace charitable giving.

Employee Perks

Sometimes, it is the little “extras” that make a big difference. Our employees receive special employee-only discounts and rates on a variety of services and memberships.

For more information on all of these Total Rewards benefits, please visitwww.employment.pa.gov and click on the benefits box.

*Eligibility rules apply.

01

Have you successfully completed, or are you withing three months of completing a bachelor’s degree? If you are claiming credits/degree, you must upload a copy of your college transcript(s) for this education to be considered in the eligibility decision. Unofficial transcripts are acceptable. You must attach your transcript(s) prior to the submission of your application by using the "Attachments" tab on the left. You will not be able to add a transcript(s) to the application after it has been submitted.

If you answer “Yes” to this question based on education acquired outside of the United States, you must upload a copy of your foreign credential evaluation report. We can only accept foreign credential evaluations from organizations that are members of the National Association of Credential Services (NACES). A list of current NACES members can be found by visitingwww.naces.organd clicking the Evaluation Services Link.

You must attach your documentation prior to the submission of your application by using the "Attachments" tab on the left. You will not be able to add a document to the application after it has been submitted.

+ Yes

+ No

02

If you are within three months of completing a bachelor’s degree, on what date do you expect to graduate? If this does not apply to you, please type N/A in the text box.

03

How many years of full-time technical experience collecting, reviewing, or evaluating information for program eligibility or insurance limits of liability do you possess?

+ 4 years or more

+ 3 but less than 4 years

+ 2 but less than 3 years

+ 1 but less than 2 years

+ Less than 1 year

+ None

04

If you are claiming experience in the above question, please list the employer(s) where you gained this experience in the text box below. The employer(s) and a description of the experience must also be included in the appropriate sections of your application if you would like the experience to be considered in the eligibility decision. If you claimed you do not have experience, type N/A in the text box below.

05

How much college coursework have you completed? If you are claiming credits/degree, you must upload a copy of your college transcript(s) for this education to be considered in the eligibility decision. Unofficial transcripts are acceptable. You must attach your transcript(s) prior to the submission of your application by using the "Attachments" tab on the left. You will not be able to add a transcript(s) to the application after it has been submitted.

If your education was acquired outside of the United States, you must upload a copy of your foreign credential evaluation report. We can only accept foreign credential evaluations from organizations that are members of the National Association of Credential Services (NACES). A list of current NACES members can be found by visitingwww.naces.organd clicking the Evaluation Services Link.

You must attach your documentation prior to the submission of your application by using the "Attachments" tab on the left. You will not be able to add a document to the application after it has been submitted.

+ 90 credits or more

+ 60 but less than 90 credits

+ 30 but less than 60 credits

+ Less than 30 credits

+ None

06

You must complete the supplemental questions below. These supplemental questions are the exam and will be scored. They are designed to give you the opportunity to relate your experience and training background to the major activities (Work Behaviors) performed in this position. Failure to provide complete and accurate information may delay the processing of your application, or result in a lower-than-deserved score or disqualification. Youmustcomplete the applicationandanswer the supplemental questions. Resumes, cover letters, and similar documents will not be reviewed for the purposes of determining your eligibility for the position or to determine your score.

All information you provide on your application and supplemental questions is subject to verification. Any misrepresentation, falsification or omission of material facts is subject to penalty. If requested, you must provide documentation, including names, addresses, and telephone numbers of individuals who can verify the validity of the information you provide in the application and supplemental questions.

Read each work behavior carefully. Determine and select which "Level of Performance" most closely represents your highest level of experience/training. List the employer(s)/training source(s) from your Work or Education sections of the application where you gained this experience/training.The "Level of Performance" you choose for each work behavior must be clearly supported within the description of the experience and training information entered in your application or your score may be lowered.In order to receive credit for experience, you must have worked in a job for at least six months in which the experience claimed was a major function.

If you have read and understand these instructions, please click on the "Yes" button and proceed to the exam questions.

If you have general questions regarding the application and hiring process, please refer to ourFAQ page (https://www.employment.pa.gov/Additional%20Info/Pages/default.aspx) .

+ Yes

07

WORK BEHAVIOR 1 – REVIEWS, EVALUATES AND ANALYZES NEW CASE REFERRALS AND DOCUMENTS

Reviews, evaluates, and analyzes new case referrals and documentation completed by medical assistance recipients involved in personal injury accidents and for medical assistance recipients' estates to determine validity, the nature of the incident, participants involved (heir, attorney, executor, insurer, defendant, etc.), dates, description of medical injuries and treatments provided, sources of medical treatment, insurance coverage, and representing attorneys and possible legal actions, if applicable.

Levels of Performance

Select the "Level of Performance" which best describes your claim.

+ A. I have experience reviewing, evaluating, and analyzing new case referrals and documentation completed by medical assistance recipients involved in personal injury accidents AND medical assistance recipients' estates to determine validity, the nature of the incident, participants involved (heir, attorney, executor, insurer, defendant, etc.), dates, description of medical injuries and treatments provided, sources of medical treatment, insurance coverage, and representing attorneys and possible legal actions, if applicable.

+ B. I have experience reviewing, evaluating, and analyzing new case referrals and documentation completed by medical assistance recipients involved in personal injury accidents OR for medical assistance recipients' estates to determine validity, the nature of the incident, participants involved (heir, attorney, executor, insurer, defendant, etc.), dates, description of medical injuries and treatments provided, sources of medical treatment, insurance coverage, and representing attorneys and possible legal actions, if applicable.

+ C. I have experience reviewing, evaluating, and analyzing new case referrals and documentation to determine validity, the nature of the incident, participants involved (heir, attorney, executor, insurer, defendant, etc.), dates, and representing attorneys and possible legal actions, if applicable. This experience was not related to medical assistance recipients' personal injury or their estates.

+ D. I have successfully completed college-level coursework related to data analysis, statistics, research methods, or business analytics.

+ E. I have NO experience or coursework related to this work behavior.

08

In the text box below, please describe your experience as it relates to the level of performance you claimed on this work behavior. Please be sure your response addresses the items listed below. If you indicated you have no work experience related to this work behavior, type N/A in the box below.

+ The name(s) of the employer(s) where you gained this experience.

+ The actual duties you performed related to reviewing, evaluating, and/or analyzing new case referrals and documentation.

+ The type(s) of documentation you reviewed, evaluated, and/or analyzed.

+ Your level of responsibility.

09

If you have selected the level of performance pertaining to college coursework, please provide your responses to the items listed below. If you indicated you have no education/training related to this work behavior, type N/A in the text box below.

+ College/University

+ Course Title

+ Credits/Clock Hours

10

WORK BEHAVIOR 2 – INVESTIGATES PERSONAL INJURY CLAIMS AND THEIR ESTATES

Investigates medical assistance recipients' personal injury claims and their estates by collecting and analyzing claim, asset and expenditure information, and by researching, interpreting and analyzing Public Welfare code, applicable Federal and State regulations and statutes, insurance laws and regulations, probate codes, and specific policy coverage in order to identify third parties or other resources available to recover payment for medical services provided to individuals as a result of a personal injury or as part of an estate recovery and determine the appropriate actions to collect recoverable provided benefits.

Levels of Performance

Select the "Level of Performance" which best describes your claim.

+ A. I have experience investigating medical assistance recipients' personal injury claims AND their estates by collecting and analyzing claim, asset and expenditure information, and by researching, interpreting and analyzing Public Welfare code, applicable Federal and State regulations and statutes, insurance laws and regulations, probate codes, and specific policy coverage in order to identify third parties or other resources available to recover payment for medical services provided to individuals as a result of a personal injury or as part of an estate recovery and determine the appropriate actions to collect recoverable provided benefits.

+ B. I have experience investigating medical assistance recipients' personal injury claims OR their estates by collecting and analyzing claim, asset and expenditure information, and by researching, interpreting and analyzing Public Welfare code, applicable Federal and State regulations and statutes, insurance laws and regulations, probate codes, and specific policy coverage in order to identify third parties or other resources available to recover payment for medical services provided to individuals as a result of a personal injury or as part of an estate recovery and determine the appropriate actions to collect recoverable provided benefits.

+ C. I have experience conducting investigations NOT related to medical assistance recipients' personal injury claims or their estates.

+ D. I have successfully completed college-level coursework related to legal investigations, employee or workplace investigations, investigative interviewing, criminal justice, or program administration.

+ E. I have NO experience or coursework related to this work behavior.

11

In the text box below, please describe your experience as it relates to the level of performance you claimed on this work behavior. Please be sure your response addresses the items listed below. If you indicated you have no work experience related to this work behavior, type N/A in the box below.

+ The name(s) of the employer(s) where you gained this experience.

+ The actual duties you performed related to conducting investigations.

+ The type(s) of investigations you have conducted.

+ Your level of responsibility.

12

If you have selected the level of performance pertaining to college coursework, please provide your responses to the items listed below. If you indicated you have no education/training related to this work behavior, type N/A in the text box below.

+ College/University

+ Course Title

+ Credits/Clock Hours

13

WORK BEHAVIOR 3 – WRITTEN COMMUNICATION

Communicates through written correspondence with attorneys, insurance companies, executors, and title companies in order to determine if another party is liable for reimbursement of medical/cash assistance relating to personal injury and estate recovery claims, or if there is pending litigation, a lawsuit settlement, or award as a result of personal injury or death.

Levels of Performance

Select the "Level of Performance" which best describes your claim.

+ A. I have experience communicating through written correspondence with ALL of the following parties: attorneys, insurance companies, executors, and title companies. This communication was regarding liability for reimbursement of medical/cash assistance relating to personal injury and estate recovery claims, pending litigation, or lawsuit settlements or awards as a result of personal injury or death.

+ B. I have experience communicating through written correspondence with at least one of the following parties: attorneys, insurance companies, executors, and title companies. This communication was regarding liability for reimbursement relating personal injury and estate recovery claims, pending litigation, or lawsuit settlements or awards as a result of personal injury or death.

+ C. I have experience communicating through written correspondence regarding determination of liability, pending litigations, or lawsuit settlements or awards not related to personal injury or estate recovery claims.

+ D. I have successfully completed college-level coursework related to business writing, technical writing, English composition, or journalism.

+ E. I have NO experience or coursework related to this work behavior.

14

In the text box below, please describe your experience as it relates to the level of performance you claimed on this work behavior. Please be sure your response addresses the items listed below. If you indicated you have no work experience related to this work behavior, type N/A in the box below.

+ The name(s) of the employer(s) where you gained this experience.

+ The actual duties you performed related to written communications and with whom (i.e., attorneys, insurance companies, executors, title companies).

+ Your level of responsibility.

15

If you have selected the level of performance pertaining to college coursework, please provide your responses to the items listed below. If you indicated you have no education/training related to this work behavior, type N/A in the text box below.

+ College/University

+ Course Title

+ Credits/Clock Hours

16

WORK BEHAVIOR 4 – PROVIDES ASSISTANCE AND GUIDANCE

Provides assistance and guidance regarding personal injury and estate recovery issues to service providers, insurers, attorneys and other interested parties.

Levels of Performance

Select the "Level of Performance" which best describes your claim.

+ A. I have experience verbally providing assistance and guidance regarding personal injury AND estate recovery issues to service providers, insurers, attorneys and other interested parties.

+ B. I have experience verbally providing assistance and guidance regarding personal injury OR estate recovery issues to service providers, insurers, attorneys and other interested parties.

+ C. I have experience verbally providing assistance and guidance to individuals regarding issues not related to personal injury or estate recovery issues.

+ D. I have successfully completed college-level coursework related to counseling, social work, human behavior, public speaking, psychology, sociology, human services, public relations, or education.

+ E. I have NO experience or coursework related to this work behavior.

17

In the text box below, please describe your experience as it relates to the level of performance you claimed on this work behavior. Please be sure your response addresses the items listed below. If you indicated you have no work experience related to this work behavior, type N/A in the box below.

+ The name(s) of the employer(s) where you gained this experience.

+ The actual duties you performed related to providing guidance and assistance and for what reason.

+ Your level of responsibility.

18

If you have selected the level of performance pertaining to college coursework, please provide your responses to the items listed below. If you indicated you have no education/training related to this work behavior, type N/A in the text box below.

+ College/University

+ Course Title

+ Credits/Clock Hours

19

WORK BEHAVIOR 5 – NEGOTIATES REIMBURSEMENTS AND REVIEWS PAYMENTS

Negotiates reimbursement of medical and cash claims with recipients, third parties, or legal professionals in order to secure financial settlements; and reviews payments received in order to resolve discrepancies with the liable party prior to processing payment.

Levels of Performance

Select the "Level of Performance" which best describes your claim.

+ A. I have experience negotiating reimbursement of medical and cash claims with recipients, third parties, or legal professionals in order to secure financial settlements; AND reviewing payments received in order to resolve discrepancies with the liable party prior to processing payment.

+ B. I have experience negotiating reimbursement of medical and cash claims with recipients, third parties, or legal professionals in order to secure financial settlements; OR I have reviewed payments received in order to resolve discrepancies with the liable party prior to processing payment.

+ C. I have experience conducting negotiations NOT related to reimbursement of medical and cash claims.

+ D. I have successfully completed college-level coursework related to finance, accounting, negotiation mastery, or conflict management.

+ E. I have NO experience or coursework related to this work behavior.

20

In the text box below, please describe your experience as it relates to the level of performance you claimed on this work behavior. Please be sure your response addresses the items listed below. If you indicated you have no work experience related to this work behavior, type N/A in the box below.

+ The name(s) of the employer(s) where you gained this experience.

+ The actual duties you performed related to negotiating reimbursements and/or reviewing payments.

+ Your level of responsibility.

21

If you have selected the level of performance pertaining to college coursework, please provide your responses to the items listed below. If you indicated you have no education/training related to this work behavior, type N/A in the text box below.

+ College/University

+ Course Title

+ Credits/Clock Hours

Required Question

Employer

Commonwealth of Pennsylvania

Address

613 North Street

Harrisburg, Pennsylvania, 17120

Website

http://www.employment.pa.gov