Eligibility Determination Specialist I

Health Research Incorporated • Menands, NY

6d • Onsite

About The Position

Responsibilities The Eligibility Determination Specialist I will assign and perform review of all Uninsured Care Program applications; handle complex hotline calls; perform quality assurance activities; and other appropriate related duties. 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.

At Health Research, Inc. (HRI), your work will contribute to meaningful change and innovation in the communities we serve! At HRI, we are on a mission to transform the health and well-being of the people of New York State through innovative partnerships and cutting-edge public health initiatives. As a dynamic non-profit organization, HRI plays a crucial role in advancing the strategic goals of the New York State Department of Health (DOH), Roswell Park Comprehensive Cancer Center (RPCCC), and other health-related entities.

Work Location Expectations At HRI, the nature of hybrid and onsite work varies by position. Some roles require full onsite presence, while others allow a hybrid schedule. Managers determine the specific telecommuting expectations for each role based on operational needs and job responsibilities. If designated as hybrid, you will divide your time between working remotely and reporting onsite. Regardless of telecommuting status, all HRI employees must live within a reasonable commuting distance of their official work location and must reside in one of the following states: New York, New Jersey, Connecticut, Massachusetts, or Vermont.

Requirements

• Bachelor's degree in a related field; OR an Associate's degree in a related field and two years of general office, secretarial, or administrative experience; OR four years of such experience.
• 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.
• This position is fully onsite and does not allow telecommuting.
• HRI participates in the E-Verify Program.

Nice To Haves

• At least one year of experience in a health care program providing services to people living with HIV/AIDS.
• At least two years of experience as a customer service representative, handling a high volume of hotline calls.
• At least one year of experience assisting clients in acquiring health care coverage through Medicare, Medicaid, and private health insurance.
• At least one year of experience reviewing commercial health insurance and COBRA coverage documents.

Responsibilities

• Assign and perform review of all Uninsured Care Program applications
• Handle complex hotline calls
• Perform quality assurance activities
• Other appropriate related duties

Benefits

• HRI offers a robust, comprehensive benefits package to eligible employees, including:
• Health, dental and vision insurance - Several comprehensive health insurance plans to choose from
• Flexible benefit accounts - Medical, dependent care, adoption assistance, parking and transit
• Generous paid time off - Paid federal and state holidays, paid sick, vacation and personal leave
• Tuition support - Assistance is available for individuals pursuing educational or training opportunities
• Retirement Benefits - HRI is a participating employer in the New York State and Local Retirement System and offers optional enrollment in the New York State Deferred Compensation Plan. HRI provides a postretirement Health Benefits Plan for qualified retirees to use towards health insurance premiums and eligible medical expenses
• Employee Assistance Program - Provides educational and wellness programs, training, and 24/7 confidential services to assist employees, both personally and professionally
• And so much more!

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Number of Employees: 501-1,000 employees