Insurance And Claims Specialist I

Health Research Incorporated • Menands, NY

11d • Onsite

About The Position

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 spenddown requirements. The Insurance and Claims Specialist I will be responsible for APIC reimbursement processing; pharmacy, primary care, home care and APIC payment processing; handle complex fiscal hotline calls; assist providers and participants with the coordination of benefits; assist with staff training; other appropriate related duties.

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.
• Valid and unrestricted authorization to work in the U.S. is required.
• Prior to hire, all HRI employees must reside within a reasonable commuting distance of their official work location and must also be located in, or willing to relocate to, one of the following states: New York, New Jersey, Connecticut, Vermont, or Massachusetts.
• Compliance with funding requirements such as time and effort reporting, grant deliverables, and contract deliverables, is required.

Nice To Haves

• At least one year of experience in a health care program providing services to people living HIV/AIDS.
• At least two years of customer service experience in a financial or medical field.
• At least two years of medical claims or insurance experience.
• Knowledge of COBRA, HIPAA, and coordination of benefits.

Responsibilities

• APIC reimbursement processing
• Pharmacy, primary care, home care and APIC payment processing
• Handle complex fiscal hotline calls
• Assist providers and participants with the coordination of benefits
• Assist with staff training
• Other appropriate related duties

Benefits

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Number of Employees: 1,001-5,000 employees