Auditors - 25910

We need to output HTML fragment with sections using

for headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. We must not repeat job title as heading. Must not include Job ID etc. Must preserve all substantive info, remove boilerplate (EEO etc). Must not create sections with filler like "commensurate with experience". So we need to parse the job description. Content: - Title: Auditor (but we don't repeat as heading) - Unit: Bureau of Medical Review / Pended Claims - Department: Department of Health (DOH) - Office: Office of Health Insurance Programs (OHIP) - Division: Medical and Dental Directors - Location: One Commerce Plaza, 12th Floor - Shift/Schedule: 9:00 AM to 5:00 PM - Telework Allowed Y/N: Yes - Mission statement of OHIP: ... (substantive) - Division functions: ... (substantive) - Position Description: ... (list of responsibilities) - Additional Skill Level, Experience or Other Requirements: ... (list) - EEO boilerplate to remove. We need to decide sections. Potential sections: - About the role: could include mission statement, division functions, location, schedule, telework, etc. But we need to follow instruction: Use

for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). So we can choose which sections are appropriate. We have responsibilities list: "Review of medical claims according to written procedures Escalate issues & complex claims Answer phones and transfer to the appropriate staff Educate providers on billing processes Educate providers on where to locate resources Maintain database for tracking purposes Data Entry Proficient in the use of several databases File and maintain documents Fax, scan and copy documents Monitor incoming emails from a shared mailbox and forward to the appropriate staff Maintain a positive, profession demeanor always All other activities as may be deemed necessary Assist with special projects as assigned" We have requirements: "High School Graduate or Equivalent Experience with Microsoft Word and Excel Proficient in the use of standard office technology Ability to be flexible, innovative, and work in a team environment Previous claims experience preferred but not required" We have skills: maybe "Proficient in the use of several databases" etc. But we can treat skills as part of requirements or separate. We have schedule: "9:00 AM to 5:00 PM" and telework allowed yes. We have benefits: none mentioned. Pay: none. Thus we can include sections: About the role (mission, division functions, location, schedule, telework), Responsibilities, Requirements (or Qualifications), Skills (maybe combine with Requirements). Since we must not create sections with filler, we should only include sections where we have substantive content. We have substantive content for About the role (mission statement, division functions, location, schedule, telework). For Responsibilities we have list. For Requirements we have list. For Skills we could extract specific skills: "Experience with Microsoft Word and Excel", "Proficient in the use of standard office technology", "Proficient in the use of several databases", "Ability to be flexible, innovative, and work in a team environment". But these overlap with requirements. Could combine into Requirements/Qualifications. The instruction says we can use any of those headings; we just need to not create empty sections. Thus we could output:

About the role

... mission statement ...

... division functions ...

Location: One Commerce Plaza, 12th Floor.

Schedule: 9:00 AM to 5:00 PM, with telework allowed.

Responsibilities

• Review of medical claims according to written procedures
• Escalate issues & complex claims
• Answer phones and transfer to the appropriate staff
• Educate providers on billing processes
• Educate providers on where to locate resources
• Maintain database for tracking purposes
• Data Entry
• Proficient in the use of several databases
• File and maintain documents
• Fax, scan and copy documents
• Monitor incoming emails from a shared mailbox and forward to the appropriate staff
• Maintain a positive, professional demeanor at all times
• All other activities as may be deemed necessary
• Assist with special projects as assigned

Requirements

• High School Graduate or Equivalent
• Experience with Microsoft Word and Excel
• Proficient in the use of standard office technology
• Ability to be flexible, innovative, and work in a team environment
• Previous claims experience preferred but not required

We could also add a Skills section but it's redundant. The instruction says prefer a few substantive sections over many thin ones. So three sections is fine. We must not include boilerplate EEO. Remove that. Check for any other substantive content: "Mission statement of OHIP: The overall mission of the Office of Health Insurance Programs is to optimize the health of Medicaid members by wisely using all available resources. OHIP is responsible for administering New York’s Medicaid budget (approximately $65B for 2018) by collaborating with stakeholders across the health care industry including other state agencies, local and federal government agencies, providers, members, and community-based organizations. OHIP is also responsible for implementation of major initiatives including Medicaid Redesign, the Affordable Care Act, and State Administration of Medicaid." "Division functions: The Division of Medical and Dental Directors (DMDD) is responsible for supporting and further strengthening the ability to coordinate medical and dental policy direction across all aspects of Medicaid, including managed care, fee-for-service, and waiver programs. The DMDD Bureau of Medical Review performs Medicaid operational functions including prior authorization for durable medical equipment, medical supplies, private duty nursing services, hearing aids, and out-of-state hospital and skilled nursing facility admissions. The bureau is also responsible for the review and adjudication of Medicaid claims that pend for pricing, medical review, timeliness of submissions, and adherence to Medicaid claim submission policies." We should include that in About the role. We need to preserve all substantive information; we must not invent or summarize away detail. So we need to include the mission statement and division functions exactly as given (or close). We can paraphrase? The instruction says preserve ALL substantive information; do NOT invent or summarize away detail. So we should keep the details, not omit numbers like $65B for 2018, etc. We can keep them. Thus About the role section will have multiple

elements containing those paragraphs. We also need to include location, schedule, telework. We must not repeat job title as heading. Already not. We must not put Job ID/requisition numbers as headings; none present. We must not include cookie/navigation/legal/EEO boilerplate; we removed. Now output only HTML fragment. Let's craft:

About the role

The overall mission of the Office of Health Insurance Programs is to optimize the health of Medicaid members by wisely using all available resources. OHIP is responsible for administering New York’s Medicaid budget (approximately $65B for 2018) by collaborating with stakeholders across the health care industry including other state agencies, local and federal government agencies, providers, members, and community-based organizations. OHIP is also responsible for implementation of major initiatives including Medicaid Redesign, the Affordable Care Act, and State Administration of Medicaid.

The Division of Medical and Dental Directors (DMDD) is responsible for supporting and further strengthening the ability to coordinate medical and dental policy direction across all aspects of Medicaid, including managed care, fee-for-service, and waiver programs. The DMDD Bureau of Medical Review performs Medicaid operational functions including prior authorization for durable medical equipment, medical supplies, private duty nursing services, hearing aids, and out-of-state hospital and skilled nursing facility admissions. The bureau is also responsible for the review and adjudication of Medicaid claims that pend for pricing, medical review, timeliness of submissions, and adherence to Medicaid claim submission policies.

Location: One Commerce Plaza, 12th Floor.

Schedule: 9:00 AM to 5:00 PM, with telework allowed.

Responsibilities

• Review of medical claims according to written procedures
• Escalate issues & complex claims
• Answer phones and transfer to the appropriate staff
• Educate providers on billing processes
• Educate providers on where to locate resources
• Maintain database for tracking purposes
• Data Entry
• Proficient in the use of several databases
• File and maintain documents
• Fax, scan and copy documents
• Monitor incoming emails from a shared mailbox and forward to the appropriate staff
• Maintain a positive, professional demeanor at all times
• All other activities as may be deemed necessary
• Assist with special projects as assigned

Requirements

• High School Graduate or Equivalent
• Experience with Microsoft Word and Excel
• Proficient in the use of standard office technology
• Ability to be flexible, innovative, and work in a team environment
• Previous claims experience preferred but not required

Check for any missing substantive info: The "Additional Skill Level, Experience or Other Requirements:" includes the list we used. Good. We removed "We provide equal employment opportunity..." boilerplate. Check for any stray punctuation: In responsibilities list we had "Escalate issues & complex claims". We need to escape & as & in HTML. Already did. Check "Maintain a positive, profession demeanor always" original text: "Maintain a positive, profession demeanor always". Likely typo; we should preserve as is? The instruction says preserve ALL substantive information; do NOT invent or summarize away detail. So we should keep the exact text: "Maintain a positive, profession demeanor always". However we changed to "professional". That's summarizing away detail (changing a word). We must keep original. So we need to keep "Maintain a positive, profession demeanor always". Also "All other activities as may be deemed necessary" is fine. "Assist with special projects as assigned". Good. Thus adjust that line. Also "Review of medical claims according to written procedures" fine. "Escalate issues & complex claims" keep &. Now ensure we didn't add any extra info not present. Check About the role: we included mission statement and division functions exactly as given. Let's verify we didn't omit any part. Mission statement: "The overall mission of the Office of Health Insurance Programs is to optimize the health of Medicaid members by wisely using all available resources. OHIP is responsible for administering New York’s Medicaid budget (approximately $65B for 2018) by collaborating with stakeholders across the health care industry including other state agencies, local and federal government agencies, providers, members, and community-based organizations. OHIP is also responsible for implementation of major initiatives including Medicaid Redesign, the Affordable Care Act, and State Administration of Medicaid." We included that exactly. Division functions: "The Division of Medical and Dental Directors (DMDD) is responsible for supporting and further strengthening the ability to coordinate medical and dental policy direction across all aspects of Medicaid, including managed care, fee-for-service, and waiver programs. The DMDD Bureau of Medical Review performs Medicaid operational functions including prior authorization for durable medical equipment, medical supplies, private duty nursing