Medicaid Eligibility Examiner 2 (NY HELPS) - 79229

Duties Description

The Medicaid Eligibility Examiner 2 (MEE 2) incumbents will work in the Division of Eligibility and Marketplace Integration within the Bureau of Third-Party Health Insurance, Medicare Savings Program and Recoveries.

Duties Will Include

Review information submitted relative to Third Party Health Insurance (TPHI) and make the necessary determination regarding when and how to update Medicaid Management Information System (MMIS).

Oversee Third Party Liability (TPL) mailbox. Clearly respond to inquiries in writing and troubleshoot Third Party Health Insurance issues.

Conduct telephone outreach to consumers and health insurance carriers.

Answer first level supervisor calls regarding more complex issues or callers requiring additional assistance.

Complete cost benefit analysis to pay health insurance premiums.

Create Health Insurance Premium Payments (HIPP) payments.

Prepare client notices and repayment agreements.

Manage and complete Medicare Buy-in activities

Utilize the shared database with CSRA, the State fiscal agent, designed to communicate and triage HIPP payment issues.

Train and supervise MEE 1/G-9 staff.

Superior phone skills and attention to detail

Permanent Transfer

Minimum Qualifications

A New York State employee with one year or more of permanent or contingent-permanent, competitive service in a position allocated to SG-12 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 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.

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 StateDepartment of Health employee with one year of permanent or contingent-permanent, competitive service as a Medicaid Eligibility Examiner 1 or Medicaid Eligibility Examiner 1 SL.

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: Preferred candidates will have strong analytical skills and the ability to pay attention to details and will also have good oral and written communication skills. Candidates should have proficiency in Microsoft Office (Word, Excel, Access); the ability to work well independently and as part of a team and to manage multiple priorities to meet deadlines. Professional experience in public health insurance programs, including New York's Medicaid, Medicare and/or Child Health Plus and supervisory experience is a plus.

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.

This position may require travel throughout New York State including overnights to areas not served by public transportation.

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...

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:

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 [email protected] to make a request.

The 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 of the position (beginning of the salary range). 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.