Insurance and Claims Specialist

Insurance And Claims Processing Specialist

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 spend-down requirements.

The Insurance and Claims Processing Specialist will be responsible for providing fiscal hotline and participant support; medical, dental, pharmacy and home care claims processing; insurance premium processing; payment reconciliation; insurance billing and account reconciliation; recovery efforts; other appropriate related duties.

Minimum Qualifications :

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

Preferred Qualifications :

• At least one year of customer service experience in a financial or medical field.
• At least one year of experience as a customer service representative, handling a high volume of hotline calls.
• At least one year of accounting experience.
• At least one year of medical claims or insurance experience.
• Bilingual : English / Spanish

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 / Protected Veterans