Auditor 25733

Job Description

Title/# of Positions/Unit: Auditor

Department: Department of Health (DOH)

Office: Office of Health Insurance Programs (OHIP)

Division: Division of Operations and Systems (DOS)

Location: 11 Corporate Woods Blvd Ste 301 Albany NY 12211

Shift/Schedule: FT

Mission statement of OHIP:

The overall mission of the Office of Health Insurance Programs is to optimize the health of Medicaid members by wisely using all available resources. OHIP is responsible for administering New Yorks Medicaid budget (approximately $65B for 2018) by collaborating with stakeholders across the health care industry including other state agencies local and federal government agencies providers members and community-based organizations. OHIP is also responsible for implementation of major initiatives including Medicaid Redesign the Affordable Care Act and State Administration of Medicaid.

Division functions: The Division of Operations and Systems (DOS) is responsible for the oversight of information systems that support the New York State Department of Health initiatives as well as the New York State Medicaid Program.

The initiatives include but are not limited to the NY State of Health (NYSOH) system the Medicaid Eligibility and Client Management (MECM) system the electronic Medicaid of New York State (eMedNY) system the Medicaid Provider Services Portal (PSP) and the Medicaid Data Warehouse (MDW). The divisions duties include oversight of the design development testing and implementation of the enhancements to these systems.

Position Description: This is a full-time position with the NYS Medicaid Programs Bureau of Provider Enrollment (BPE). BPE staff are responsible for enrolling and revalidating providers in NYS Medicaid and maintaining provider records in eMedNY.

This includes:

• Ensuring that the application and required documentation are complete current and valid
• Navigating various federal and State databases including Medicares enrollment system (PECOS) and other states licensing verification websites
• Contacting providers via email or phone if information is incomplete or requires further clarification
• Entering and updating provider information in eMedNY
• Meeting production and quality standards

Additional Skill Level Experience or Other Requirements:

• Strong computer skills including proficiency in Microsoft Office internet navigation and data entry
• Excellent organizational skills including the ability to prioritize work assignments
• Ability to be flexible innovative and work independently with minimal supervision and as a team member
• Strong communication skills (written and verbal)
• Previous experience in health care office health insurance and/or the public or non-profit sectors (Preferred)
• Previous data entry and data validation experience (Preferred)
• Previous customer service experience (Preferred)