Review Vacancy
TitleMedical Assistance Specialist 1 – 88282 (HELPS)
Occupational CategoryClerical, Secretarial, Office Aide
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $65001 to $82656 Annually
Street Address OHIP Division of Medical and Dental Directors, Bureau of Medical Review
One Commerce Plaza
Minimum Qualifications This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS). HELPS Program titles may be filled via a noncompetitive
appointment. This means that you do not need to take an exam to qualify, but you do need to meet the minimum qualifications of the title.
If you are hired under the HELPS Program, you will be first be appointed as a temporary employee. In May 2024, if you are performing successfully in the position, your appointment will be changed from temporary to permanent non-competitive. Once you are in permanent status, your official probationary period will begin and you may take any promotion exam for which you are qualified.
At a future date (within one year of permanent appointment), employees hired under NY HELPS are expected to have their permanent non-competitive
employment status converted to permanent competitive status. You will not have to take an exam to gain permanent competitive status.
Non-Competitive Minimum Qualifications : Either 1: Six years of qualifying experience;
Or 2: an Associate's degree AND four years of qualifying experience;
Or 3: a Bachelor's or higher degree AND two years of qualifying experience.
Permanent Transfer: Current Department of Health (DOH) employees with permanent or contingent-permanent status as a Medical Assistance Specialist 1; OR current NYS employee with one year or more of permanent or contingent-permanent, competitive service in a title eligible to transfer under Section 52.6, Section 70.1 of the Civil Service Law to a Medical Assistance Specialist 1. For more information on the types of transfers, transfer eligibility criteria, and the current transfer determinations for your title, visit the following website.
https://careermobilityoffice.cs.ny.gov/cmo/gotit/index.cfm.
Preferred Qualifications: Supervision experience and knowledge of Microsoft Office Suite, Medicaid program, and or eMedNY system preferred.
Duties Description The incumbent will provide supervision for first-line claims review staff within the Pended Claims Unit of the Bureau of Medical Review. Duties include providing guidance to staff on workflow priorities, developing training materials for new procedures, ensuring staff proficiency in new procedures, performing quality assurance activities for first-line review staff, monitoring error rates and claims adjudication volumes for performance assessment, and handling escalated claim reviews and inquiries from first-line staff. The incumbent will also conduct complex research and verification of claims payment history for providers, communicate verbally and in writing with healthcare providers and their legal representatives, provide guidance and support to staff in applying departmental policies, objectives, and priorities regarding review of delayed claims review, make determinations on payment requests for claims pending in eMedNY system, and undertake additional duties as needed to achieve the objectives of the Bureau.
Additional Comments The Medical Assistance Specialist I, G-18 position will be assigned to the Medical Pended Claims unit within the Division of Medical and Dental Directors' Bureau of Medical Review. This unit is responsible for review of Medicaid claims pended for timely filing, requests for two-year waiver of claims processing, high-cost outlier claims review, and other claims pending for eMedNY system edits.
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/MAS1/88282 (HELPS)
Email Address resume@health.ny.gov
Address
Street Room 2217, Corning Tower Building, 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/MAS1/88282(HELPS) included in the subject line or by mail to Human Resources Management Group, EM/MAS1/88282(HELPS), 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.