Insurance and Claims Specialist

Compensation Grade:

Compensation Details:

Department

Job Description:

Responsibilities

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.

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.

Minimum Qualifications

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.

Preferred Qualifications

• 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

Conditions of Employment

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.

This position requires that the incumbent will report to the official work location and live within commuting distance to the official work location. Telecommuting will not be available.

HRI participates in the E-Verify Program.

HRI has a long-standing dedication to diversity, equity, and inclusion in our workforce. HRI is committed to the principle of non-discrimination in all phases of its employment procedures and practices.

Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

www.healthresearch.org

About Health Research, Inc.

Join us in our mission to make a difference in public health and advance scientific research! 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, HRIplays 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.