Review Vacancy
AgencyAttorney General, Office of the
TitleSenior Consumer Frauds Representative or Consumer Frauds Representative Trainee (NY HELPS)
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $50844 to $80655 Annually
Appointment Type Contingent Permanent
Duties Description This position is within the Health Care Bureau (Albany) of the OAG.
Consumer Fraud Representatives at the OAG mediate consumer complaints of fraud, perform field investigations and activities related thereto, and conduct consumer education and outreach programs to provide individuals with information regarding their rights under Consumer Protection Law. Duties may include, but are not limited to, the following:
Processes consumer inquiries and formal complaints:
• Responds to online complaints and telephone consumer intake questions.
• Assist consumers with a variety of health care complaints, including, but not limited to billing and claims reimbursement disputes; denials of coverage for medical treatment, prescriptions, and medical devices; incorrect processing of medical, mental health and substance abuse claims; access to specialty and transitional care; termination of health plan coverage; denials of COBRA or New York State Continuation of Coverage.
• Assist consumers with billing disputes involving debt collectors and finance companies seeking payment on behalf of medical/ dental providers.
• Interviews complainants, respondents, health care providers, and third parties to obtain any necessary additional information needed to effectively advocate for consumers.
• File written and/ or telephone inquiries with health plans and health plan providers.
• Review health plan documents, claim forms, Explanation of Benefits Statements, and billing statements.
• Compiles informational material for use by staff and for distribution to callers and complainants.
• Evaluates all incoming correspondence directed to the Health Care Bureau Helpline, identifies proper jurisdiction, and assigns routine correspondence to support staff.
• Responds to inquiries, informs consumers of their legal rights, advises them of complaint filing procedures, assist with appeals/grievances, or refers them to other government or private agencies.
• Appraises formal written consumer complaints for mediation
• Responds to requests filed under the Freedom of Information Law (FOIL).
• Coordinates mutually satisfactory resolutions for complainants and respondents and resolve complaints through mediation.
• Monitor health plans for violations of State and federal laws and recommends litigation when a violation exists. Also, monitor health plans to ensure timely responses to authorization requests for medical care (including specialty care) and prescriptions.
Assist attorneys with investigation and prosecution of consumer fraud cases and provide consumer outreach:
• Assembles, labels, catalogs, and arranges evidence for potential investigations or enforcement actions.
• Interviews witnesses and prepares memoranda.
• Coordinates with Assistant Attorney General/ Helpline Manager to identify cases involving potential violations or systemic issues that may warrant investigation as fraudulent or unfair business practices. Enters descriptions in electronic database and aid in generating reports based on key words and categories. Arranges, files, and tracks associated documents in case management software.
• Monitors refunds, restitution monies, judgments and settlement sand closes case files.
• Monitors workflow and reviews case recommendations.
• Compiles educational Health Care Bureau pamphlets and offers suggestions for additional information that may be helpful, for dissemination to libraries, civic groups, and individuals.
• Administers consumer surveys.
• Answers inquiries referred by Constituent Services Bureau and the Public Relations Office.
• Assist in the preparation of Health Care Bureau newsletters and Helpline Report, including highlighting noteworthy outcomes for publication.
• Perform other duties as assigned.
Minimum Qualifications NY HELPS:
This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS).
For the duration of the NY HELPS Program, this title may be filled via a non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the title for which they apply.
At a future date (within one year of permanent appointment), it is expected employees hired under NY HELPS will have their non-competitive employment status converted to competitive status, without having to compete in an examination. Employees will then be afforded with all of the same rights and privileges of competitive class employees of New York State. While serving permanently in a NY HELPS title, employees may take part in any promotion examination for which they are qualified.
NON-COMPETITIVE QUALIFICATIONS:
• Senior Consumer Frauds Representative (PEF SG 17, current starting salary $63,361, job rate $80,655)
A paralegal degree or paralegal certificate program or 60 semester credit hours and five years of experience primarily dealing with the general public in a sales or consumer/customer service or problem resolution capacity.
• Consumer Frauds Representative Trainee 2 (PEF SG NS, current starting salary $53,764, job rate $68,630)
A paralegal degree or paralegal certificate program or 60 semester credit hours and three years of experience primarily dealing with the general public in a sales or consumer/customer service or problem resolution capacity.
• Consumer Frauds Representative Trainee 1 (PEF SG NS, current starting salary $50,844, job rate $65,061)
A paralegal degree or paralegal certificate program or 60 semester credit hours and two years of experience primarily dealing with the general public in a sales or consumer/customer service or problem resolution capacity.
OTHER WAYS TO QUALIFY:
Reachable on the Department of Civil Service Eligible list for Senior Consumer Frauds Representative.
OR
Eligible for a lateral transfer or eligible for transfer under 70.1 of the Civil Service Law by having one year of permanent competitive service in an appropriate title. To determine if your current Civil Service title is eligible for transfer to this title, visit the Career Mobility GOT-IT website.
OR
55 B/C: This position is eligible for 55b/c appointment, and candidates with 55b/c eligibility are encouraged to apply. To be eligible for a 55b/c appointment, the candidate must be enrolled in the Civil Service 55b/c program and meet the minimum qualifications listed above.
Additional Comments Candidates from diverse backgrounds are encouraged to apply. The OAG is an equal opportunity employer and is committed to workplace diversity.
As an employee of the OAG, you will join a team of dedicated individuals who work to serve the people of our State through a wide variety of occupations. We offer a comprehensive New York State benefits package, including paid leave, health, dental, vision, and retirement benefits, and family-friendly policies. Additionally, the OAG offers a robust Workplace Flexibilities Program with multiple options for employees, including telecommuting (up to two days per week) and alternative work schedules.
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 (OSC) in accordance with NYS Civil Service Law, OSC Payroll rules and regulations, and negotiated union contracts.
The Office of the NYS Attorney General (OAG) cannot provide sponsorship for work authorization. Candidates need to be authorized to work in the United States to be employed by this agency. It is incumbent upon employees to maintain work authorization for the duration of their employment with the OAG.
Some positions may require additional credentials or a background check to verify your identity.
Email Address HR.Recruitment@ag.ny.gov
Address
Street Office of the New York State Attorney General
The Capitol
Notes on ApplyingIn your submission, you must provide sufficient information to determine from your resume and/or cover letter that you meet the minimum qualifications stated above. If a certificate or degree is required to demonstrate that you meet the minimum qualifications, you must provide proof that you hold the required certificate or degree.
To apply, please send your resume, cover letter, and a copy of your degree/transcript (if applicable) to HR.Recruitment@ag.ny.gov. Be sure to include the Vacancy # 203863 and Title of the position in the subject heading of your email.
For more information about the OAG, please visit our website: www.ag.ny.gov.