Medicaid Eligibility Examiner II - Compliance & Audits
New York State Department of Health
The New York State Department of Health is hiring a Medicaid Eligibility Examiner in Albany, NY. This role involves conducting initial and peer post-eligibility reviews to ensure compliance with eligibility determinations and working with external auditors to facilitate assessments. Preferred qualifications include experience in public health insurance programs such as Medicaid and Medicare, alongside strong analytical and communication skills. This position offers a comprehensive benefits package worth 65% of the salary and is committed to promoting health equity and social determinants of health. #J-18808-Ljbffr New York State Department of Health
- Overview The Bureau of Program Compliance and Audit (BPCA) interacts with... ...the Center for Medicare and Medicaid Services (CMS) to ensure that... ...New York State of Health eligibility determinations are in compliance... ...as a Medicaid Eligibility Examiner 2, SG-14, OR a New York...SuggestedPermanent employmentFull timeTemporary workWork at officeLocal areaVisa sponsorshipShift workNight shift
$36.23k - $52.41k
...Agency Health, Department of Title Medicaid Eligibility Examiner 1 / Trainee (NY HELPS) - Multi... ...track evidence-gathering progress, auditing incoming documentation for completeness... ...ensuring all activities remain in strict compliance with state deadlines and HIPAA...SuggestedPermanent employmentFull timeTraineeshipWork at officeLocal areaRemote workVisa sponsorshipShift work- ...contractor, health plan and local district compliance with State and Federal eligibility rules and regulations.... ...Conduct Child Health Plus (CHPlus) and Medicaid initial and peer post-eligibility... ...service as a Medicaid Eligibility Examiner 1 (G9) OR a NYS employee with one...SuggestedPermanent employmentFor contractorsTraineeshipWork at officeLocal areaVisa sponsorshipShift work
- Job Description The Enrollment Resolution Examiner is responsible for resolving complex enrollment... ...and Health Plan Enrollment data through audit and review, utilizing the internal and... ...other lines of business as requested. Level II Mentors and collaborates with others on...SuggestedWork experience placementWork at officeRemote workWork from homeHome officeFlexible hours
$20.02 - $34.92 per hour
Capital District Physicians Health Plan Inc in New York is seeking an Enrollment Resolution Examiner responsible for resolving complex enrollment and billing issues. The role requires three years of financial data or Health Insurance Enrollment experience and proficiency...SuggestedRemote jobWork at office- ...to the Government in civil HCF matters (E.g., Medicare data, Medicaid data, outlier data). - Communication skills: Ability to... ...qualifications: - Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3. - Relevant...Full timeWork experience placementWork at officeLocal area
$66.33k - $145.86k
...investigations and contributes to organizational compliance with federal and state regulations. The... ...Certifications such as Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud... ...relevant factors. This position is eligible for a CVS Health bonus, commission or short...Hourly payFull timeTemporary workLocal area$13.97 - $26.71 per hour
...Branch Manager or Field Leader, the Mobile Examiner's primary responsibility is to provide... ...the future through a 401(k) Plan with eligibility for all employees after one month, and... ...i.e. Procedure Manuals, Safety Manual, Compliance Manual, Automobile policies and...Work experience placementWork at officeImmediate startFlexible hoursAfternoon shiftWeekday work$13.97 - $26.71 per hour
...Branch Manager or Field Leader, the Mobile Examiner's primary responsibility is to provide... ...the future through a 401(k) Plan with eligibility for all employees after one month, and... ...: Procedure Manuals, Safety Manual, Compliance Manual, Automobile policies and procedures...Work experience placementWork at officeImmediate startFlexible hoursAfternoon shiftWeekday work- Clough AMEC. is seeking an Investigator for the New York State Inspector General (OIG) office in Albany, NY. This role requires handling sensitive investigations regarding fraud, corruption, and criminal activity within state agencies. The ideal candidate should have five...Work at office
- ...The Examiner At CDL Schools The Examiner at CDL Schools administers CDL Skills Exams (vehicle inspection, basic control skills, road... ...and maintains proper documentation. Main Focus Area #1: Compliance Maintain your certification as a state CDL Examiner, to include...
- A leading health services organization is seeking a Mobile Examiner to perform mobile exams and specimen collections accurately and on... ...with various patient demographics and upholding safety and compliance standards in all exams conducted. #J-18808-Ljbffr Quest Diagnostics...Flexible hours
- Quest Diagnostics is seeking a Mobile Examiner in Albany, NY, responsible for conducting mobile exams and ensuring accurate specimen collection. The role requires strong phlebotomy skills, flexibility in travel, and excellent customer service abilities. Candidates should...
- Workers Compensation Clams Examiner | CT, MA, NH, RI, VT Jurisdictions | License Required To analyze Lost-Time Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations...Flexible hours
- ...degree and three years of relevant experience, particularly in healthcare fraud investigations. This position offers opportunities for professional growth and requires U.S. citizenship and clearance eligibility. #J-18808-Ljbffr CGS Federal (Contact Government Services)
- QUEST DIAGNOSTICS INC is hiring a Mobile Examiner in the Town of Guilderland, NY. The role involves collecting specimens, conducting exams, and ensuring accurate record-keeping. Candidates must possess a high school diploma, a minimum of one-year phlebotomy experience,...Flexible hours
$127.51k - $160.91k
...seeking a Supervisory Field Support Lead in Albany, NY. This role requires extensive experience in financial examinations, emphasizing examiner development and compliance with regulatory standards. The candidate will reinforce training and best practices among examiners and...- A leading government service provider is seeking a Healthcare Fraud Investigator to provide legal support for a significant government project. This role requires a strong background in healthcare fraud investigations, effective communication skills, and proficiency with...
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