Medicaid Eligibility & Fair Hearing Specialist

HRA/DEPT OF SOCIAL SERVICES; New York (NY); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

55a Program

Public Service Loan Forgiveness

Job summary

The City of New York’s Department of Social Services (DSS) / HRA is seeking four Eligibility Specialists, Level II for Fair Hearing Administration. You will determine PHI eligibility, contact appellants, and process extensions of medical coverage while maintaining detailed case logs.

Ideal candidates will have strong knowledge of Medicaid eligibility and related systems (WMS, FHIS, EmedNY) and be able to meet tight deadlines in a state agency setting. Residency required.

Qualifications

• Experience interviewing, gathering information and preparing documentation for eligibility for public assistance or unemployment benefits.
• Ability to determine PHI eligibility based on laws, rules, regulations, and procedures.
• Strong written and verbal communication with applicants and end-users.

Responsibilities

• Gather information on client eligibility for PHI from forms, in person, or by phone to ensure compliance with state fair hearings decisions.
• Determine PHI eligibility and examine Aid to Continue eligibility and its impact on cases.
• Process extension of medical coverage and manage clock-down lists for hearings not yet scheduled.
• Provide information regarding PHI eligibility to clients via telephone and in person.
• Transmit and review MAP-316P forms for withdrawal of fair hearing requests and maintain client contact logs.

Job description

The City of New York’s Department of Social Services (DSS) / HRA is seeking four Eligibility Specialists, Level II for Fair Hearing Administration. You will determine PHI eligibility, contact appellants, and process extensions of medical coverage while maintaining detailed case logs.

Ideal candidates will have strong knowledge of Medicaid eligibility and related systems (WMS, FHIS, EmedNY) and be able to meet tight deadlines in a state agency setting. Residency required.