Review Vacancy
TitleMedicaid Eligibility Examiner 1 Trainee - (HELP)
Occupational CategoryOther Professional Careers
Bargaining UnitASU - Administrative Services Unit (CSEA)
Salary RangeFrom $34152 to $49405 Annually
Minimum Qualifications The Medicaid Eligibility Examiner Trainee title is part of the NYS HELP program. For the duration of the HELP Program, this title will be filled via permanent non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the titles for which they apply. At the close of the HELP program, employees hired under the HELP Program will have their non-competitive employment status converted to competitive status. Employees will then be afforded with all of the same rights and privileges of competitive class employees of New York State. Depending on how the candidates qualifies, the positions could be filled as competitive or non-competitive.
Non-Competitive (HELP): There are no minimum education or experience requirements. If you are appointed to a Trainee title, upon successful completion of a 12 month traineeship, you will automatically advance to the full journey level of the title, Grade 9.
Permanent Transfer: Current NYS employee with one year or more of permanent or contingent-permanent, competitive service as a Medicaid Eligibility Examiner Trainee (G6) OR a NYS employee with one year or more of permanent or contingent-permanent, competitive service in a position eligible for transfer under Section 70.1 of the Civil Service Law. A list of transferrable titles can be found at https://www.cs.ny.gov/businesssuite/title-transfer-matrix.cfm.
Preferred Qualifications: Preferred candidates will have experience in public health insurance programs, including New York’s Medicaid, Medicare and/or Child Health Plus. Preferred candidates will also have excellent verbal and written communication skills; strong analytical skills and attention to detail; strong organizational skills; proficiency in Microsoft Office (Word, Excel, Access); the ability to work well independently and as part of a team, and to manage multiple priorities in order to meet deadlines; and experience using electronic data systems, such as eMedNY and NYSOH Back Office.
Duties Description The Medicaid Eligibility Examiner positions are located within the Office of Health Insurance Programs, Division of Eligibility and Marketplace Integration. Duties may include but not be limited to:
• Gathering medical evidence for Medicaid disabilities determinations
• Communicating with applicants, physicians’ offices, hospitals, and other health care providers to gather the documentation necessary for a Medicaid disability determination to be conducted
• Researching suspected duplicate Client Identification Numbers (CIN) for an accurate determination of the CIN being assigned to the same or different enrollee
• Maintaining and updating tracking reports
• Conducting quality assurance reviews and assisting in the development of policies/procedures for specific case scenarios
• Analyzing and verifying Third Party Health Insurance (TPHI) relative to client information and perform verifications and determinations as they apply to Medicaid Managed Care enrollment
• Determining when action is necessary regarding recovery of capitation payments and directing the necessary information to the appropriate individual or unit to initiate the recovery process
• Gathering information from employers and/or insurance carriers for determining cost-effectiveness of TPHI
• Reviewing and resolving JIRA issues related to returned premium reimbursement checks, stop payment and reissue requests, 90-day letters, and payments received.
Additional Comments The positions may be filled in Albany or New York City. New York City employees will receive a downstate adjustment of $3,026.
We offer a work-life balance and a generous benefits package, worth 65% of salary, including:
• Holiday & Paid Time Off
• Public Service Loan Forgiveness (PSLF)
• Pension from New York State Employees’ Retirement System
• Shift & Geographic pay differentials
• Affordable Health Care options
• Family dental and vision benefits at no additional cost
• NYS Deferred Compensation plan
• Access to NY 529 and NY ABLE College Savings Programs, and U.S. Savings Bonds
• And many more...
For new State employees appointed to graded positions, the annual salary is the hiring rate (beginning of the Salary Range) of the position. Promotion salaries are calculated by the NYS Office of the State Comptroller in accordance with NYS Civil Service Law, OSC Payroll rules and regulations and negotiated union contracts.
The NYS Department of Health is committed to making New York a safer, healthier, and more equitable place to live. Understanding health equity, social determinants of health and health disparities is critical to accomplish our goal of eliminating health disparities. For more information on the NYS Department of Health’s Mission, Vision, Values and Strategic Plan, please visit: https://health.ny.gov/commissioner/index.htm
Some positions may require additional credentials or a background check to verify your identity.
Name Human Resources Management Group, EM/MEE1TR/HELP
Email Address resume@health.ny.gov
Address
Empire State Plaza
Notes on ApplyingPlease submit your resume and cover letter as one (1) document, preferably in PDF format, by email to resume@health.ny.gov, with Reference EM/MEE1TR/HELP included in the subject line or by mail to Human Resources Management Group, EM/MEE1TR/HELP, Rm 2217, Corning Tower Building, Empire State Plaza, Albany, NY 12237-0012, or by fax to (518) 473-3395. Failure to include the required information may result in your resume not being considered for this position.