Medicaid Integrity Specialist 1FA/Trainee 1 FA/Trainee 2 FA- NY HELPS - 2 Positions

The duties that the incumbent of the vacancy will be expected to perform. Duties Description New York State leads the nation in developing a robust culture of Medicaid program integrity and healthcare compliance. Formed in 2006 to more efficiently use resources dedicated to fighting fraud, waste, and abuse, we are a small agency with a big impact! To fulfill its mission, the Office of the Medicaid Inspector General (OMIG) performs audits, investigations, and reviews of Medicaid services and providers and works with other federal and state agencies that have regulatory oversight or law enforcement powers. Each year, the agency has identified or recovered billions of dollars in cost avoidance and recoveries to offset Medicaid program costs. OMIG staff primarily work on Medicaid program integrity functions. These positions include auditors, investigators, nurses, data analysts, pharmacists, other clinical/medical professionals, compliance specialists, program administrators/managers, and persons providing legal, technological, and administrative support, in seven offices across the State.For more information on the NYS Office of the Medicaid Inspector General’s Mission, please visit: https://omig.ny.gov/about-us/about-omigThese positions are in the System Match and Recovery Unit (SMR) in OMIG’s Division of Medicaid Audit. The SMR unit audits providers for their compliance with Medicaid rules and regulations as they pertain to claims that are submitted to the Medicaid program for payment. Provider claim billing and Plan reported encounter issues for SMR audits are identified and analyzed solely using internal and external data systems. Audits performed by the SMR unit are issued in bulk format, span a variety of provider types, and include both fee-for-service claims and encounter records. Responsibilities of a Medicaid Integrity Specialist (FA) in the SMR unit include, but are not limited to: performing tasks associated with the preparation of Draft Audit Reports, managing and maintaining a caseload of multiple provider audits across many Medicaid provider types, sending out correspondence and communicating with providers via telephone and email, reviewing documentation submitted by providers, researching Medicaid laws and New York State regulations, Medicaid provider manuals and policies to ensure recoveries are consistent with audit findings, preparing and issuing Final Audit Reports and updating internal database systems with pertinent audit information.

The minimum qualifications required for this vacancy. Minimum Qualifications GENERAL PUBLIC CANDIDATES: Possession of a bachelor's degree* or higher. No experience is required for appointment as a Trainee 1.*Your degree must have been awarded by a college or university accredited by a regional, national, or specialized agency recognized as an accrediting agency by the U.S. Department of Education/U.S. Secretary of Education. If your degree was awarded by an educational institution outside the United States or its territories, you must provide independent verification of equivalency. This information can be found at http://www.cs.ny.gov/jobseeker/degrees.cfm. Candidates are responsible for the evaluation fee.CURRENT NYS EMPLOYEES: New York State employees with one year of permanent competitive service in a title deemed eligible for transfer under Section 52.6 or 70.1 of the Civil Service Law.To determine if your current Civil Service title is eligible for transfer to this title, visit the Career Mobility GOT-IT website: Career Mobility Office » GOT-IT (ny.gov)PREFERRED QUALIFICATIONS: Proficiency in the use of Word and Excel; excellent verbal and written communication skills; strong analytical skills and attention to detail; and the ability to work with others to resolve conflicts.

Additional comments regarding the vacancy. Additional Comments FREE PARKINGNOTE ON TELECOMMUTING: OMIG employees may be approved for a maximum of 50% telecommuting, however, they are required to apply and obtain approval through management in accordance with OMIG's Telecommuting Program Guidelines.Specific hours for each position to be discussed at time of interview.Permanent, Full-Time, Competitive (for transfers and appointments off a list), Non-Competitive (for appointments through the NY HELPS Program). Trainee 1 salary starts at $53,764. Salary is non-negotiable.**The Department of Civil Service has developed the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS), which is a streamlined program that allows appointment to this title and others without examination. For the duration of the NY HELPS program, this title, may be filled via permanent, non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the titles for which they apply. Benefits of Working for NYSGenerous benefits package, worth 65% of salary, including: Holiday & Paid Time Off• 13 paid holidays annually• Up to 13 days of paid vacation leave annually• Up to 5 days of paid personal leave annually • Up to 13 days of paid sick leave annually for PEF/CSEAHealth Care Benefits• Eligible employees and dependents can pick from a variety of affordable health insurance programs.• Family dental and vision benefits at no additional costAdditional Benefits• New York State Employees’ Retirement System (ERS) Membership• NYS Deferred Compensation• Access to NY 529 and NY ABLE College Savings Programs, as well as U.S. Savings Bonds• Public Service Loan Forgiveness (PSLF)And many more.

Some positions may require additional credentials or a background check to verify your identity.

Salary : $53,764