Medicaid Eligibility Examiner 1 (3 positions)
||New York State Department of Health
||Medicaid Eligibility Examiner 1 (3 positions)
||Division of Legal Affairs, NY State of Health Counsel, Bureau of Appeals, Corporate Woods, Albany, New York
||Candidates must be a current NYS County Department of Social Services employee with permanent competitive status and have one (1) or more years of service as a Social Welfare Examiner, Social Services Examiner, Eligibility Examiner 1, Social Services Program Specialist, Senior Clerk, or in a position where the work involves responsibility for performing assignments in connection with determining financial eligibility, categorical classification, continued financial eligibility, and income maintenance. The work must involve the review and evaluation of applications and records, and interviewing with applicants.
||The preferred candidate will have experience with the Appeal process currently performed at the Local Departments of Social Services.
||Within the Division of Legal Affairs, NY State of Health Counsel, Bureau of Appeals, the incumbents of these positions will provide support activities related to appeals from eligibility determinations made by the NY State of Health, Health Plan Marketplace; assist with the scheduling of hearings and desk reviews; coordinate with the customer service provider regarding the processing of appeals requests; make arrangements for off-site hearings; provide technical assistance on eligibility policy for Medicaid, CHP, advanced premiums tax credits and cost sharing reductions; assist legal staff; and perform functions necessary to assume the responsibilities of the Local Departments of Social Services pertaining to eligibility for health insurance programs and hearings regarding eligibility determinations . Duties include: processing consumer appeals; coordinating with the customer service provider regarding appeals requests; processing requests for reconsiderations and further appeals; preparing, maintaining and distributing appeals files: assisting the legal staff; entering changes into NY-HX to effectuate appeal determinations; uploading decisions to the HX systems; reviewing cases with respect to status, aid to continue, compliance and related issues; handling additional evidence received at hearings and making sure that evidence is properly stored; resolving discrepancies in various data match processes; ensuring systems are operated in a manner consistent with federal and state statute and regulations; assisting in the implementation of policy and regulation changes; working collaboratively with other DOH program areas to identify and discuss administrative changes, recommendations and suggestions to improve operations and solve problems; and researching applicant status, prior history, the status of appeals requests; and payment history, utilizing various data storage and retrieval systems.
|Conditions of Employment
||Permanent appointment, full-time.
||Submit resume to Human Resources Management Group, MEE1/15265/RD, Room 2217, Corning Tower Building, Empire State Plaza, Albany, New York 12237-0012, or by e-mail to firstname.lastname@example.org or by fax to (518) 473-3395. Please use a subject line of MEE1/15265/RD.
|Submit resumes by
||Until positions are filled
An affirmative action/equal opportunity employer. Women, minorities and people with disabilities are encouraged to apply.