Insurance and Claims Specialist I

Compensation Grade:

Compensation Details:

Department

Job Description:

Responsibilities

The New York State Department of Health, AIDS Institute has established eight Uninsured Care Programs, of which some of these programs have the most comprehensive drug and service coverage in the country. The programs provide access to medical services and medications for all New York State residents with or at risk of acquiring HIV/AIDS. The programs bridge the gap between Medicaid coverage and private insurance and serve as a transition to Medicaid by providing interim assistance to individuals eligible for but not yet enrolled in Medicaid or assistance in meeting spenddown requirements.

The Insurance and Claims Specialist I will be responsible for APIC reimbursement processing; pharmacy, primary care, home care and APIC payment processing; handle complex fiscal hotline calls; assist providers and participants with the coordination of benefits; assist with staff training; other appropriate related duties.

Minimum Qualifications

Bachelor's degree in a related field; OR an Associate's degree in a related field and two years of general office, secretarial, or administrative experience; OR four years of such experience.

Preferred Qualifications

• At least one year of experience in a health care program providing services to people living HIV/AIDS.

• At least two years of customer service experience in a financial or medical field.

• At least two years of medical claims or insurance experience.

• Knowledge of COBRA, HIPAA, and coordination of benefits.

Conditions of Employment

Grant funded position. Compliance with funding requirements such as time and effort reporting, grant deliverables, and contract deliverables, is required.

Valid and unrestricted authorization to work in the U.S. is required. Visa sponsorship is not available for this position.

The selected candidate must reside within a reasonable commuting distance of the official work location specified in the job posting and must also be located in or willing to relocate to one of the following states: New York, New Jersey, Connecticut, Vermont, or Massachusetts, prior to hire. Telecommuting will not be available.

HRI participates in the E-Verify Program.

Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

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About Health Research, Inc.

Join us in our mission to make a difference in public health and advance scientific research! At Health Research, Inc. (HRI), your work will contribute to meaningful change and innovation in the communities we serve! At HRI, we are on a mission to transform the health and well-being of the people of New York State through innovative partnerships and cutting-edge public health initiatives. As a dynamic non-profit organization, HRIplays a crucial role in advancing the strategic goals of the New York State Department of Health (DOH), Roswell Park Comprehensive Cancer Center (RPCCC), and other health-related entities.