Medicaid Quality Control Auditor

NYC Department of Social Services; New York (NY); Sur place; USD 70 000 - 90 000; Plein temps

Résumé du poste

NYC Department of Social Services is seeking a Principal Administrative Associate II to function as a Quality Control Case Reviewer within the Medicaid Quality Control Unit. The role focuses on reviewing MAP and HCSP cases, verifying data accuracy across HRA Viewer, WARM, eMedNY, SOLQ, and SAVE, and preparing audit summaries for internal and external reviewers.

Applicants must meet civil service qualifications and possess strong knowledge of Medicaid policies, auditing experience, and excellent

Qualifications

• Bachelor's degree with two years of clerical/administrative experience, one year in supervisory capacity.

Responsabilités

• Conduct monthly review of MAP MICSA and HCSP cases.
• Retrieve client information from HRA Viewer, WARM, eMedNY, SAVE and SOLQ.
• Ensure the review sample is auditable and identify inconsistencies.
• Review Medicaid procedures and identify contradictions; report findings.
• Prepare case review summaries and respond to external auditors.

Connaissances

Medicaid policies knowledge

Medicaid audits

Audit findings documentation

Respond to auditors

ADM/GIS/LDM

WMS

EmedNY

Medicaid Edits

CentraPort

SOLQ

SAVE

Word

Excel

Supervising staff

Analytical skills

Site visits for training

Excellent communication

Formation

Bachelor’s degree with 2 years experience

Associate degree with 3 years experience

High school diploma with 4 years experience

Outils

WMS

EmedNY

Medicaid Edits

CentraPort

SOLQ

SAVE

MS Word

MS Excel

Description du poste

NYC Department of Social Services is seeking a Principal Administrative Associate II to function as a Quality Control Case Reviewer within the Medicaid Quality Control Unit. The role focuses on reviewing MAP and HCSP cases, verifying data accuracy across HRA Viewer, WARM, eMedNY, SOLQ, and SAVE, and preparing audit summaries for internal and external reviewers.

Applicants must meet civil service qualifications and possess strong knowledge of Medicaid policies, auditing experience, and excellent