Auditors - 25872

Department of Health (DOH), Office of Health Insurance Programs (OHIP), Division of Operations and Systems

Location: 11 Corporate Woods, Albany, 3rd FL

About the role

This is a full-time position with the NYS Medicaid Program’s Bureau of Provider Enrollment (BPE). BPE staff are responsible for enrolling, revalidating, and maintaining Medicaid provider files in the eMedNY system and/or in the Provider Services Portal (PSP).

Responsibilities

• Ensure that applications and required documentation submitted in the PSP are complete, current, and valid, and that data entered into the PSP complies with federal and State requirements, policies, and procedures.
• Navigate various federal and State databases, including Medicare’s enrollment system (PECOS), the NPI Registry (NPPES), the New York State Education Department’s (NYSED’s) Office of the Professions Verification Search, and other states’ licensing verification websites, to verify information supplied on an application is current and valid.
• Contact providers via the PSP, email, or phone in a clear, concise, and professional manner if information is incomplete or requires further clarification.
• Enter and update provider information in eMedNY and/or the PSP.
• Meet production and quality standards.
• File, maintain, and upload documents according to procedures.

Requirements

• High school graduate or equivalent
• Strong computer skills, including proficiency in Microsoft Office and internet navigation
• Strong communication skills (written and verbal)
• Excellent organizational skills
• Ability to be flexible, innovative, work independently, recognize and manage priorities with minimal supervision, and work as a team member

Preferred Qualifications

• Previous experience reviewing, verifying, validating detailed/sensitive information using web-based verification sources
• Data entry experience
• Previous customer service experience

Schedule

• 37.5 - 40 hours per week, between the hours of 7:30 AM – 4:30 PM (30-minute unpaid break)
• After training and upon approval of bureau management, telecommuting up to 50% of the pay period may be available
• Employees are requested to refrain from taking time off during the initial training period, up through the first 90 days to ensure the best learning outcomes