Medicaid Eligibility Verification Specialist

Responsibilities

• Review and analyze Medicaid Assistance case records and computer data to determine eligibility for State and Federal funding
• Identify retroactive obligations and determine effective dates for reimbursements
• Resolve duplicate Client Identification Numbers (CIN) identified by OMIG and OSC
• Prepare Turnaround Documents (TADS) for demographic changes to improve clearance matches
• Review Invalid Social Security Number Validation files to minimize audit disallowances and fraud
• Perform quality assurance for Enterprise Data Warehouse (EDW) and Medicaid Data Warehouse (MDW) queries
• Complete manual case lookups for press inquiries, FOIL requests, and senior staff requests
• Create case records utilizing WMS, HRA One Viewer, SAVE, eMedNY, and other agency systems

Requirements

• Permanent status in the Principal Administrative Associate civil service title
• Baccalaureate degree and 3 years of progressive clerical/administrative experience (including 1 year of supervisory experience)
• OR Associate degree and 4 years of progressive clerical/administrative experience (including 1 year of supervisory experience)
• OR High school diploma and 5 years of progressive clerical/administrative experience (including 1 year of supervisory experience)

About the Company

The Department of Social Services (DSS) comprises the administrative units of the New York City Human Resources Administration (HRA) and the Department of Homeless Services (DHS), dedicated to fighting poverty and addressing homelessness in New York City.