Medical Assistance Specialist 1 - 88282
Albany, New York
Employer: StateJobsNY
Industry: Clerical, Secretarial, Office Aide
Salary: Competitive
Job type: Full-Time
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.
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.
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
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 Applying Please 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 included in the subject line or by mail to Human Resources Management Group, EM/MAS1/88282, 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.
https://careermobilityoffice.cs.ny.gov/cmo/gotit/index.cfm.
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.
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
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 Applying Please 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 included in the subject line or by mail to Human Resources Management Group, EM/MAS1/88282, 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.
Created: 2024-06-12
Reference: 160538
Country: United States
State: New York
City: Albany
ZIP: 12208
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