Insurance and Claims Specialist I JR-00000703

Overview

Health Research, Inc. (HRI) contributes to the health and well-being of the people of New York State by complementing and enabling the strategic public health goals of the New York State Department of Health (DOH), Roswell Park Cancer Institute Corporation (RPCIC), and other health-related entities.

HRI provides best-in-class resource administration for stakeholders and programs related to the work and priorities of the Department of Health and its other partners. HRI does this through the provision of knowledge, expertise, funding guidance, and fiduciary oversight of sponsored program funding for public health and research programs in concert with community partnerships.

Health Research, Inc. (HRI) offers a robust, comprehensive benefits package to eligible employees, including:

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;
And so much more!
Job Description:

Responsibilities

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.

Minimum Qualifications

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.

Preferred Qualifications

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.
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