Insurance and Claims Specialist
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 spend- down requirements. The Insurance and Claims Processing Specialist will be responsible for providing fiscal hotline and participant support; medical, dental, pharmacy and home care claims processing; insurance premium processing; payment reconciliation; insurance billing and account reconciliation; recovery efforts; other appropriate related duties.
Requirements
- Bachelor's degree in a related field; OR an Associate's degree in a related field and one year of general office, secretarial, or administrative experience; OR three years of such experience.
- 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.
- Telecommuting will not be available.
- HRI participates in the E-Verify Program.
Nice To Haves
- At least one year of customer service experience in a financial or medical field.
- At least one year of experience as a customer service representative, handling a high volume of hotline calls.
- At least one year of accounting experience.
- At least one year of medical claims or insurance experience.
- Bilingual: English/Spanish
Responsibilities
- providing fiscal hotline and participant support
- medical, dental, pharmacy and home care claims processing
- insurance premium processing
- payment reconciliation
- insurance billing and account reconciliation
- recovery efforts
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Industry
Professional, Scientific, and Technical Services
Number of Employees
1,001-5,000 employees
