Position Information

NY HELPYes

AgencyHealth, Department of

TitleMedicaid Eligibility Examiner 1/Trainee (NY HELPS) - 79022, 15252, 15455, 79129, 15254, 15465, 79021

Occupational CategoryOther Professional Careers

Salary Grade09

Bargaining UnitASU - Administrative Services Unit (CSEA)

Salary RangeFrom $35177 to $50884 Annually

Employment Type Full-Time

Appointment Type Contingent Permanent

Jurisdictional Class Competitive Class

Travel Percentage 0%

Schedule

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 9 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? Yes

Location

County Albany

Street Address Division of Eligibility and Marketplace Integration/Bureau of Third Party Health Insurance, Medicare Savings Program and Recoveries

99 Washington Avenue

City Albany

StateNY

Zip Code12210

Job Specifics

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):
Medicaid Eligibility Examiner 1: Two years of experience determining or reviewing financial eligibility for healthcare or consumer-assisted programs to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations or performing quality assurance activities to ensure compliance with laws, rules, regulations, and policies in a health care delivery system including health care facilities; federal, State, or local health care agencies; hospitals; Medicaid programs; and/or other public or private health insurance programs.

30 semester credit hours can substitute for one year of experience.

Medicaid Eligibility Examiner Trainee 1: 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 strong analytical skills and the ability to pay attention to details and will also have good oral and written communication skills. Candidates should have proficiency in Microsoft Office (Word, Excel, Access); the ability to work well independently and as part of a team and to manage multiple priorities to meet deadlines. Professional experience in public health insurance programs, including New York's Medicaid, Medicare and/or Child Health Plus and supervisory experience is a plus.

Duties Description These Medicaid Eligibility Examiner 1 (MEE 1) positions will work within the Bureau of Third-Party Health Insurance, Medicare Savings Program and Recoveries. Duties may include, but not be limited to:

• Review information submitted to Third-Party Liability Bureau (TPL) from a variety of sources including, but not limited to, Medicaid Managed Care Organizations (MMC), other internal units/Bureaus. Make the necessary determination regarding any necessary updates to eMedNY and possible MMC premium recovery.
• Analyze and verify Third Party Health Insurance (TPHI) relative to client information and perform verifications and determinations as they apply to Medicaid Managed Care enrollment.
• Determine when action is necessary regarding recovery of capitation payments and direct the necessary information to the appropriate individual or unit to initiate the recovery process.
• Take appropriate actions regarding Medicaid enrollment and premium reimbursement.
• Create and modify HIPP/MIPP payees as necessary.
• Gather information from employers and/or insurance carriers for determining cost-effectiveness of TPHI.
• Calculate the cost-effectiveness of TPHI using the HIPP calculator in eMedNY.
• Communicate via phone with MMC Plans, carriers, clients and coworkers.
• Handle incoming phone calls from Medicaid clients with questions about their premium reimbursement checks. Review eMedNY, NYSoH, KTT, and JIRA to determine the status of checks and assist clients in resolving their questions.
• Review and resolve JIRA issues related to returned premium reimbursement checks, stop payment and reissue requests, 90-day letters, and payments received.

Additional Comments This position is part of the NYS HELPS program. No examination is required.

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.

Contact Information

Name Human Resources Management Group, EW/MEE1/MULTI

Telephone 518-486-1812

Fax 518-473-3395

Email Address resume@health.ny.gov

Address

Street Room 2217, Corning Tower Building, Empire State Plaza

City Albany

State NY

Zip Code 12237

 

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 EW/MEE1/MULTI included in the subject line or by mail to Human Resources Management Group, EW/MEE1/MULTI, 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.