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Commonwealth of Pennsylvania |
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POSITION DESCRIPTION FOR JOB POSTING |
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Position Number: 00221702 |
Description Activated On: 2/5/2026 4:53:39 PM |
Position Purpose: Describe the primary purpose of this position and how it contributes to the organization’s objectives. Example: Provides clerical and office support within the Division to ensure its operations are conducted efficiently and effectively. This position provides technical and administrative support to the Coverage and Compliance Division within the Bureau of Mcare to ensure health care providers (HCPs) and professional corporations, professional companies, associations, and partnerships have the appropriate medical professional liability insurance coverage and to ensure HCPs' compliance with Pennsylvania insurance laws and regulations. |
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Description of Duties: Describe in detail the duties and responsibilities assigned to this position. Descriptions should include the major end result of the task. Example: Types correspondence, reports, and other various documents from handwritten drafts for review and signature of the supervisor. 1. Controls the Remittance Advice Resource Account for receiving of Remittance Advice (Form e-216),which is the form used by primary and self -insurers to report medical malpractice insurance data, information, and assessment/surcharge payments to Mcare, on a daily basis. 2. Examines and reviews medical malpractice insurance filings and funds to provide coverage for HCPs, professional corporations, professional companies, professional associations, and partnerships prior to the Coverage Specialist performing a more thorough and professional analysis of the data. 3. Analyzes supporting documentation such as worksheets, Articles of Incorporation, and partnership agreements to determine eligibility for Mcare participation. 4. Prepare Form e-216s for electronic downloading process. 5. Utilizes the General Insurance Underwriting System (GENIUS/Emcee) for maintaining Mcare’s coverage records and to ensure inclusion of current information. 6. Notifies appropriate internal and external personnel when inaccurate or incomplete information is received. 7. Analyzes reports from licensing agencies, such as Department of Health and Department of State, to determine licensees’ eligibility to participate in Mcare. 8. Generates reports using Microsoft Access and Excel, and analyzes those reports of HCPs who will receive a variety of letters regarding compliance issues with their medical professional liability insurance coverage. 9. Makes recommendations to and assist in the preparation of reporting guidelines and procedures for medical professional liability insurance carriers and producers to maintain the integrity of coverage data submitted to Mcare for determining liability, exposure, risk factors and compliance with Pennsylvania insurance laws and regulations. 10. Recommends improvements to internal processes and procedures to increase efficiency within the Unit. 11. Identifies problems using Microsoft Access and recognize appropriate solutions as a result of the analysis of data. 12. Assists with preparing annual assessment manuals and Form e-216 in response to changes in legislation, policy or procedures. 13. Performs reconciliations of processed Form e-216s. 14. Performs an analysis and evaluation of HCPs' coverage history to validate and substantiate retroactive dates for claims made or occurrence plus coverage reported by primary medical professional liability insurance carriers and producers. 15. Serves as point of contact for credentialing organizations. Reviews and replies to correspondence from credentialing agencies, determining if proper signed releases from the HCP have been submitted prior to releasing information deemed confidential. 16. Prepares and distributes various statistical reports using Microsoft Access, Excel, Outlook and Word. 17. Serves as Unit’s content administrator for DocuShare, Mcare’s document management system. 18. Provides training and assistance to staff with regarding e-216 process, DocuShare, Excel and Access. 19. Performs other related duties as assigned. |
Decision Making: Describe the types of decisions made by the incumbent of this position and the types of decisions referred to others. Identify the problems or issues that can be resolved at the level of this position, versus those that must be referred to the supervisor. Example: In response to a customer inquiry, this work involves researching the status of an activity and preparing a formal response for the supervisor’s signature. Responsible for determining HCPs' Mcare eligibility. Determines if Form e-216s are ready to be downloaded. Reviews and analyzes a variety of medical professional liability insurance documents to determine the appropriateness for review by a Coverage Specialist. Assignments are reviewed through reports and audits for conformance with program, Commonwealth, Department, and Bureau’s policies and procedures. |
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Requirements Profile: Identify any specific experience or requirements, such as a licensure, registration, or certification, which may be necessary to perform the functions of the position. Position-specific requirements should be consistent with a Special Requirement or other criteria identified in the classification specification covering this position. Example: Experience using Java; Professional Engineer License Experience: Licenses, registrations, or certifications: 1. N/A 2. N/A 3. N/A 4. 5. 6. |
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Essential Functions: Provide a list of essential functions for this position. Example: Transports boxes weighing up to 60 pounds.
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