MEDICAID ELIGBILITY SPECIALIST
MEDICAID ELIGBILITY SPECIALIST
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Salary Not Disclosed
1 Vacancy
Job Description
IF YOU ARE HIRED PROVISIONALLY IN THIS TITLE YOU MUST TAKE AND PASS THE CIVIL SERVICE EXAM WHEN IT BECOMES AVAILABLE TO BE ELIGIBLE FOR CONTINUED EMPLOYMENT.
Salary range: $42485.00 $48858
The Medical Assistance Program (MAP) administers public health insurance programs including Medicaid for the City of New York. Applying individuals and families are approved for eligibility against applicable Federal and State guidelines. Those found to be eligible can use coverage provided to access doctors medication and other health care services at little or no cost.
The Medical Assistance Program (MAP) is recruiting for Six (6) Eligibility Specialists II to function as Medicaid Eligibility Specialists in various MAP Offices who will:
Conduct a comprehensive review of applications including financial and legal documentation as well as paid or unpaid medical bills submitted by applicants/recipients and authorized representatives.
Perform budget calculations obtain clearance reports resolve resource matches and initiate other case actions utilizing the Eligibility Data and Image Transfer System (EDITS) Welfare Management System (WMS) MAP PayIn System eMedNY and the HRA One viewer.
Determine eligibility for the appropriate level of Medicaid coverage for MAGI and NonMAGI applicants and recipients.
Prepare eligibility forms and notices to inform applicants and recipients of case disposition.
Interview and/or review documentation submitted by applicants and recipients or authorized representatives to determine eligibility for Medicaid.
Respond to inbound and outbound telephone calls received from clients and/or authorized representatives with inquiries related to Medicaid coverage including possible questions related to the Excess Income Program or the applicant or recipients responsibility towards the cost of their care (NAMINet Available Monthly Income) if institutionalized.
Assists consumers who need further assistance in understanding the eligibility criteria to qualify for the Excess Income Program.
Perform other related assigned duties.
Qualifications :
1. Completion of 30 semester credits at an accredited college or university; or
2. A four high school diploma or its educational equivalent and one year of fulltime satisfactory experience in one or more of the following areas; performing the work described below:
a. Interviewing gathering information and/or preparing necessary documentation for the purpose of making recommendations concerning eligibility for public assistance or unemployment health benefits social security insurance or participation in social services or community programs and other similar benefits; or
b. Performing bookkeeping bank teller duties housing office teller duties purchasing agent assistant store manager sales representative responsible for accounts or customer service duties or a job in which the duties include helping customers with questions or concerns; or
c. Dealing with social service agencies legal representatives or aiding individuals in navigating housing social financial or health problems or application systems; or
3. A satisfactory combination of education and/or experience equivalent to 1 or 2 above. College education may be substituted for the experience in 2 above on the basis that 30 semester credits from an accredited college or university may be substituted for each year of required experience. However all candidates must have at least a four year high school diploma or its educational equivalent.
Special Note
Work experience which provides only incidental opportunities to perform the job duties as described in 2a 2b and 2c above are not acceptable for meeting the minimum qualification requirements.
Additional Information :
The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected characteristic including but not limited to an individuals sex race color ethnicity national origin age religion disability sexual orientation veteran status gender identity or pregnancy.
Remote Work :
No
Employment Type :
Fulltime
Employment Type
Full-time
