Review Vacancy
TitleMedicaid Eligibility Examiner 2 (NY HELPS) - 79252, 79407
Bargaining UnitASU - Administrative Services Unit (CSEA)
Salary RangeFrom $59049 to $71719 Annually
Appointment Type Contingent Permanent
Duties Description 1. Support Hearing Officers in preparing for and conducting appeal hearings, and issuing Appeal Decisions:
Assist in preparing case folders for each hearing at least two weeks prior to the scheduled hearing. Case folders must contain all necessary material required by the Hearing Officer for the hearing; including timely notice of hearing, appropriate evidence packet and other documents relevant to the issue under appeal.
Assist in scheduling or re-scheduling of Appeal Hearings if necessary;
Research and update Hearing Officers on the status of individual appeal requests;
Provide support to Hearing Officers and staff regarding access to the IT systems and the information necessary to conduct hearings and issue Decisions. This may include requesting call recordings for individual accounts through the Customer Service vendor; or assisting in the scheduling of hearing rooms and conference rooms.
2. Proof-read and complete Quality Assurance review of all Notices of Decision and Dismissal issued by the Appeals Unit.
All Decisions prepared by Hearing Officers must be reviewed to assure that the Name, Mailing Address, Account Number and Appeal Number of the appellant is accurate at the beginning of the Decision and at the end of the Decision.
The body of each Decision and Dismissal must be proof-read and reviewed to assure that there are no missing fields or formatting mistakes. For example, a field marked “DATE” that does not include a calendar date.
3. Oversee exhibit process daily; monitor secure appeals fax machine, check for new exhibits a minimum of three times daily; maintain evidence log; deliver exhibits to hearing officers and securely transmit exhibits to be uploaded into appellant’s account; ensure that complete and unaltered exhibits are uploaded.
4. Oversee expedited appeals process daily; monitor incoming expedited appeal requests throughout the day and adhere to overall tracking process for expedited appeal requests; assist Supervising Hearing Officer in charge of process.
5. Assist in the weekly redaction of personally identifiable information (“PII”) from Decisions and Dismissals prepared by the Appeals Unit that are posted for the public.
6. Provide back-up as necessary in maintaining data regarding the Appeals Unit operations and preparing data summaries and required reports regarding the activity of the Unit.
7. Monitor Appeals Inbox for incoming correspondence and process documentation/requests when needed.
8. Other duties as assigned.
Minimum Qualifications Permanent Transfer:
A New York State employee with one year or more of permanent or contingent-permanent, competitive service in a position allocated to SG-12 or above and eligible for transfer under Section 70.1 of the Civil Service Law.
Non-Competitive Candidates via NY HELPS Program:
Either 1. Three years of experience performing one or more of the following activities in a health care delivery system including health care facilities, health care agencies, hospitals, Medicaid programs, and/or other public or private health insurance programs
•Determining financial eligibility for healthcare to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations.
•Performing quality assurance activities to ensure compliance with laws, rule, regulations and policies and interpretation/application of standards of health care.
OR 2. 30 semester credit hours AND two years of experience performing one or more of the following activities in a healthcare delivery system including health care facilities, health care agencies, hospitals, Medicaid programs, and/or other public or private health insurance programs
•Determining financial eligibility for healthcare to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations.
•Performing quality assurance activities to ensure compliance with laws, rule, regulations and policies and interpretation/application of standards of health care.
Provisional Appointment: In the absence of an eligible list with three or more candidates willing to accept a position, a temporary provisional appointment may be considered. For provisional appointment, candidates must meet one of the following minimum qualifications: Current New York State Department of Health employee with one year of permanent or contingent-permanent, competitive service as a Medicaid Eligibility Examiner 1 or Medicaid Eligibility Examiner 1SL.
If three or fewer New York State Department of Health promotional candidates respond to this notice, the agency may, at its discretion, nominate a qualified employee for non-competitive promotion under the provisions of Section 52.7 of the Civil Service Law.
Preferred Qualifications: Strong organizational skills; Excellent communication skills, both written and verbal; Experience with health insurance programs, including Medicaid; Experience with prepping file folders for Administrative Hearings
Additional Comments When reviewing qualifications, omissions and vagueness cannot be interpreted in the candidate’s favor. Candidates are responsible for providing accurate and clear descriptions of their experience demonstrating how they meet the minimum qualifications.
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...
NYS Department of Health does not participate in E-Verify and does not sponsor visa applications.
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.
If you require reasonable accommodation to complete a job application, a job interview or to otherwise participate in the hiring process, please contact by phone 518-486-1812 or email doh.sm.reasonable.accommodation@health.ny.gov to make a request.
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/MEE2/MULTI
Email Address resume@health.ny.gov
Address
Street Corning Tower, Empire State Plaza, Room 2217
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/MEE2/MULTI included in the subject line or by mail to Human Resources Management Group, EM/MEE2/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.