Job Summary - Why you’ll love this position
The MO Medicaid Audit & Compliance Unit (MMAC) has an opening for a Benefit Program Senior Specialist within the Provider Review Unit located in Cole County.
Job Posting Number: 4016 8260103 & 8260112
Semi-monthly salary: The current rate for this position is $2,020.69. Individual(s) selected for this position may receive a higher rate based on a pay differential (e.g. shift, or time-of-service pay).
Annual salary: $48,496.65
Job Location: This position is located at the Knipp Building; 3418 Knipp Drive, Jefferson City, MO. All internal promotional applicants are encouraged to apply as there may be alternate office space available.
The Department of Social Services partners with families and communities to protect children, rehabilitate youth and move families to self-sufficiency so that Missourians can lead safe, healthy and productive lives.
Why you’ll love this position: This position offers the opportunity to work with a dedicated team committed to protecting the integrity of the Missouri State Medicaid Program. Your work will help detect and prevent fraud, waste, and abuse; identify improperly expended Medicaid funds; and support efforts to ensure high‑quality care for Missouri citizens.
In this position you will work with a dedicated team of employees while gaining new and valuable skills. This is an independent position responsible for monitoring compliance for programs administered by Department of Mental Health.
Responsibilities - What you’ll do
- Conduct post-payment review of MO HealthNet claims ensuring providers are appropriately billing and providing services in accordance with federal and state regulations and MO HealthNet requirements.
- Review and understand MO HealthNet policies and procedures in assigned programs related to Department of Mental Health programs.
- Initiative to research policies and procedures to make determinations on what enforcement activities to pursue, such as education, demand of repayment and/or prepayment review from information obtained.
- Become well-informed and knowledgeable regarding the review process and any findings so that an effective testimony can be provided at an Administrative Hearing Commission.
- Manage a case load that consists of analyzing and selecting claim samples, review of medical record documentation to support billings, prepare written reports regarding any findings, and make determinations on what administrative action to pursue, such as, education, demand of repayment and/or prepayment review.
- Communicate effectively with other state agencies, providers, and coworkers regarding program requirements related to the reviewing of MO HealthNet providers.
- Monitor corrective action plans, recovery of identified overpayments and provide assistance to Unit Supervisor or other designated management or executive staff.
- May require the coordination and review of special projects, the development and management of tracking files, and coordinating efforts between other MHD units or other agencies.
- You may also be required to present at the MO HealthNet workshops for your program(s) on behalf of MMAC.
- Desk and onsite audits (which will require some travel).
- The individual in this position must be prepared to use his/her own professional judgment.
- General computer knowledge and be proficient in Word and Excel.
- Requires a significant amount of reading.
Qualifications - All you need for success
Minimum Qualifications:
Bachelor’s degree and 1-3 years of relevant experience. (Substitutions may be allowed.)
Preferred Qualifications:
The person in this position should possess the following knowledge, skills, and abilities:
- Great written and verbal communication skills.
- Ability to work independently or in a team structure.
- Demonstrate organizational skills, multitask while also prioritizing tasks.
- Demonstrate and initiate problem solving.
- Ability to communicate with stakeholders, contract vendors, and providers
- Attention to details.
- Understand the analysis of data and comprehend the results.
- Dependable.
- Training or education in Leadership.
Lack of post‐secondary education will not be used as the sole basis denying consideration to any applicant.
Job Details - More reasons to love this position
The State of Missouri offers an excellent benefits package that includes a defined pension plan, generous amounts of leave and holiday time, and eligibility for health insurance coverage. Your total compensation is more than the dollars you receive in your paycheck. To help demonstrate the value of working for the State of Missouri, we have created an interactive Total Compensation Calculator. This tool provides a comprehensive view of benefits and more that are offered to prospective employees. The Total Compensation Calculator and other applicant resources can be found here.
Contact Details - If you have questions or require any accommodations to participate in the application or interview process please contact:
If you have questions about this position please contact: Spenser Epple at [email protected] . If you experience accessibility issues while applying, please contact Courtney Hall at [email protected].
Recruitment Area: All qualified applicants.
Application Deadline: July 23, 2026
The State of Missouri is an equal opportunity employer and is committed to developing and maintaining a talented workforce.
