City of New York

Job Description

APPLICANTS MUST BE PERMANENT IN THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE.

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.

Medicaid Reimbursement Unit under the general direction of the -Director and/or the Deputy Director with latitude for the exercise of independent initiative and judgement, performs specialized administrative work supervising the functions of the Medicaid Reimbursement units who processes invoices for payment of insurance premiums for Medicaid transportation, Home Care Reimbursement, Premium Payment and Medicaid Reimbursement Services:

MAP Third Party Health Insurance Program (TPHI) is recruiting for one (1) Principal Administrative Associate, Level III who will function as a Section Manager within the Third Party Health Insurance Program (TPHI), who will:

• Review and sign off on invoices for eligibility determinations prepared by eligibility and supervisory staff on the Medicaid consumers’ requests for insurance premium cost effective review for Medicaid reimbursable insurance premium payments.
• Forward invoices to the HRA Office of Finance for payment in a timely manner to avoid insurance policy cancellation. Verify correct payment was made to the proper insurance company through the Financial Management System (FMS).
• Contact the Comptroller’s Office to track and retrieve overpayment of redirect reimbursement checks of clients who have moved out of state or deceased.
• Coordinate the work of unit supervisors and their subordinate staff who are involved in interviewing, reviewing, processing applications for reimbursement to Medicaid clients’ out of pocket medical expenses.
• Interact with other MAP program areas, insurance companies, outside agencies, and Medicaid clients in order to meet program objectives.
• Resolve health insurance reinstatement issues with the State Department of Health (SDOH) Commissioner by conducting research and contacting insurance providers whenever the insurance company indicates that a client is not part of their health plan; ensure SDOH reinstates the client to their previous health insurance plan.
• Prepare monthly reports on the units’ activities for submission to the Third Party/Medicaid Reimbursement Director.
• Perform hands on training with staff to ensure that performance deficiencies are corrected; ensure that Medicaid reimbursement eligibility determination is consistent with applicable laws and regulations.
• Monitor time and leave records for subordinates and evaluate staff performance on an on-going basis.
• Be responsible in the temporary absence of the Third Party/Medicaid Reimbursement Director, Assistant Director, the Section Manager may assume the duties of that position.

Hours/Schedule: 9 am – 5 pm (Flex)

Salary Range: $64,137 - $73,758

PRINCIPAL ADMINISTRATIVE ASSOC - 10124

Qualifications

1. A baccalaureate degree from an accredited college and three years of satisfactory full-time progressively responsible clerical/administrative experience, one year of which must have been in an administrative capacity or supervising staff performing clerical/administrative work of more than moderate difficulty; or

2. An associate degree or 60 semester credits from an accredited college and four years of satisfactory full-time progressively responsible clerical/administrative experience including one year of the administrative supervisory experience described in "1" above; or

3. A four-year high school diploma or its educational equivalent approved by a State's department of education or a recognized accrediting organization and five years of satisfactory full-time progressively responsible clerical/administrative experience including one year of the administrative supervisory experience as described in "1" above;

4. Education and/or experience equivalent to "1", "2", or "3" above. However, all candidates must possess the one year of administrative or supervisory experience as described in "1" above. Education above the high school level may be substituted for the general clerical/administrative experience (but not for the one year of administrative or supervisory experience described in "1" above) at a rate of 30 semester credits from an accredited college for 6 months of experience up to a maximum of 3½ years.

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 individual's sex, race, color, ethnicity, national origin, age, religion, disability, sexual orientation, veteran status, gender identity, or pregnancy.