Medical Records Examiner

Medical Records Examiner

Salary

$67,736.00 - $102,905.00 Annually

Location

Dauphin County, PA

Job Type

Civil Service Permanent Full-Time

Job Number

CS-2026-50569-39570

Department

Department of Human Services

Division

HS Div Prgm Pvdr Anlys

Opening Date

06/03/2026

Closing Date

6/17/2026 11:59 PM Eastern

Job Code

39570

Position Number

Multiple positions my be filled from this posting.

Union

FOP Lodge 92

Bargaining Unit

G4

Pay Group

ST08

Bureau / Division Code

00211792

Bureau / Division

Bureau of Program Integrity / Division of Program & Provider Compliance

Worksite Address

Commonwealth Tower

Worksite Address

303 Walnut Street

City

Harrisburg, Pennsylvania

Zip Code

17101

Contact Name

Ricki Paden

Contact Email

ripaden@pa.gov

• Description
• Benefits
• Questions

THE POSITION

As a Medical Records Examiner with the Department of Human Services (DHS), you will play a key part in maintaining the standards of medical services across the state. This position gives you the chance to use your clinical background while supporting the fair use of Medical Assistance resources. You will help identify discrepancies, promote compliance, and conduct reviews of provider practices. This role provides a rewarding way to make a difference in public service.

DESCRIPTION OF WORK

This position reviews and evaluates medical services provided under the Medical Assistance Program to help ensure that care meets required standards. The work supports the detection of potential fraud, waste, and abuse while maintaining program integrity. As a Medical Records Examiner, you will perform the following duties:

• Case Review: Examine medical records, claims, and related documents to identify issues with compliance or quality of care
• Data Analysis: Evaluate provider invoicing patterns and service histories to detect irregularities
• Case Coordination: Organize review steps, track progress, and keep supervisors informed of case developments
• Report Preparation: Write clear summaries of findings, methods, and recommendations for administrative action
• Meetings and Testimony: Participate in discussions with supervisors and legal staff and provide testimony when required
• Provider Communication: Respond to tips, complaints, and referrals from various sources and document actions taken

Interested in learning more? Additional details regarding this position can be found in the position description.

Work Schedule and Additional Information:

• Full-time employment, 37.5 hours per week
• 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 three 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:

• Three years of professional experience in the field of medical assistance, health care services, or human services; or
• An equivalent combination of experience and training.

Special Requirements:

• You must possess active authorization to practice as a Registered Nurse in Pennsylvania.
• All employees possessing an active temporary practice permit must obtain licensure as a Registered Nurse within the one (1) year period defined by the Pennsylvania State Board of Nursing.
• You must be in possession of an active motor vehicle license.

Other Requirements:

• You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency Guidelines.
• You must be able to perform essential job functions.

How to Apply:

• Resumes, cover letters, and similar documents will not be 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.
• All application materials and interview responses must reflect the applicant's own experience, qualifications, and work. Applicants may use generative AI tools for preparation purposes only. Use of AI to misrepresent or falsify information, or to assist during interviews, is not permitted. Review the Guidance for Generative AI Tools & Job Seekers for additional information.

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/test once for this posting.

• Your results will be provided via email.

Learn more about our Total Rewards by watching this short video!

See the total value of your benefits package by exploring our benefits 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 visit www.employment.pa.gov and click on the benefits box.

• Eligibility rules apply.

01

Special Requirement- Do you possess a valid drivers license which is not under suspension?

• Yes
• No

02

If you answered "Yes" to the previous question, please provide the issuing state and license number. If you answered "No" type N/A in the box.

03

You must complete the supplemental question(s) below. Failure to provide complete and accurate information may delay the processing of your application or result in a lower-than-deserved score or disqualification. You must complete the application and answer the supplemental question(s). 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 question(s) is subject to verification. Any misrepresentation, falsification or omission of material facts is subject to penalty.

Read the question(s) carefully. Determine and select the option that most closely represents your highest level of experience/training/certification. The option you choose must be clearly supported if requested.

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 our FAQ page.

• Yes

04

Special Requirement - Do you possess active authorization to practice as a Registered Nurse in Pennsylvania; or do you possess an active temporary permit to practice as a Registered Nurse in Pennsylvania?

• Yes
• No

05

If yes, please list the state that issued your license, your license number, and the expiration date. If you answered no to the question above, please type N/A in the box below.

06

How many years of full-time professional experience do you possess in the field of medical assistance, health care services, or human services?

• 3 years or more
• 2 but less than 3 years
• 1 but less than 2 years
• Less than 1 year
• None

07

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.

08

How much graduate coursework have you completed in addiction studies; health and risk communication; health care administration/management; health care informatics/information management; health economics; health education; health insurance studies; health leadership; health policy; health sciences; health services; occupational health and safety; occupational therapy; quality, safety and risk management in health care; physical therapy; psychology; public health; social work; speech therapy; or vocational rehabilitation?

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 visiting www.naces.org and 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.

• 60 credits or more
• 45 but less than 60 credits
• 30 but less than 45 credits
• 15 but less than 30 credits
• Less than 15 credits
• None

Required Question

Employer Commonwealth of Pennsylvania

Address 613 North Street

Harrisburg, Pennsylvania, 17120

Website http://www.employment.pa.gov