Provider Enrollment Specialist
2 days ago
Albany
Job Description JOB-19210 Provider Enrollment Specialist-25488 Shift/Schedule: 40 hours, between the hours of 7:30 – 5:00 (30 Min unpaid break). After training and review, telecommuting up to 50% of the pay period may be available upon successful completion of training and review, to ensure competency. 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 Operations and Systems (DOS) is responsible for the oversight of information systems that support the New York State Department of Health initiatives as well as the New York State Medicaid Program. The initiatives include, but are not limited to, the NY State of Health (NYSOH) system, the electronic Medicaid of New York State (eMedNY) system and the design, development, testing, implementation and daily use of the new Medicaid Provider Services Portal (PSP). Position Description: This is a full-time position with the NYS Medicaid Program’s Bureau of Provider Enrollment (BPE). BPE staff are responsible for enrolling and revalidating providers in NYS Medicaid and maintaining provider records in eMedNY. This includes: • Ensuring that the paper application and required documentation are complete, current, and valid, and data entered by fiscal agent into tracking system is consistent with the submitted application adhering to Federal and State, requirements, policies and procedures., • Navigating various Federal and State databases, including Medicare’s enrollment system (PECOS), NPI Registry (NPPES), New York State Education Department, Office of the Professions Verification Search, and other states’ licensing verification websites, to verify information supplied on application is current and valid., • Contacting providers via email or phone if information is incomplete or requires further clarification in a clear, concise, tactful manner., • Entering and updating provider information in eMedNY, • Meeting production and quality standards, • File, maintain, upload documents according to procedures in a timely manner, • 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. Additional Skill Level, Experience or Other Requirements: • Previous experience reviewing, verifying, validating detailed/sensitive information using web-based verification sources (Preferred), • Data entry experience (Preferred), • Strong computer skills, including proficiency in Microsoft Office, internet navigation (Preferred), • Strong communication skills (written and verbal), • Previous customer service experience, • Excellent organizational skills, • Ability to be flexible, innovative, work independently, recognize and manage priorities with minimal supervision and as a team member. Our extensive consultant placements cover a variety of roles, from Technical Architects and Specialists to Developers, Project Managers, Analysts, Executive Secretaries, Nurses, Dietitians, Paralegals, Computer Operators, Food Preparation Workers, and many other occupations. To date, KBI has successfully placed over 1,000 consultants across more than 100 private sector companies and public sector agencies in New York State and throughout the country. We are dedicated to recruiting candidates who consistently exceed our customers’ expectations. We provide equal employment opportunity for all applicants and employees regardless of race, color, sex, gender identity, gender expression, religion, age, national origin, citizenship, disability, medical condition, family care status, marital status, domestic partner status, sexual orientation, genetic information, military/veteran status, or any other protected basis.Established in 2005, Knowledge Builders Inc. (KBI) offers a wide range of services, including Information Technology Consulting, Administrative and Health Care Staffing solutions, Payrolling, and Call Center services to organizations of all sizes, including both private companies and governmental entities. KBI is a certified Woman-Owned Business Enterprise (WBE) recognized by New York State, New York City, and the Port Authority of New York and New Jersey.\r\n\r\nOur extensive consultant placements cover a variety of roles, from Technical Architects and Specialists to Developers, Project Managers, Analysts, Executive Secretaries, Nurses, Dietitians, Paralegals, Computer Operators, Food Preparation Workers, and many other occupations. To date, KBI has successfully placed over 1,000 consultants across more than 100 private sector companies and public sector agencies in New York State and throughout the country.\r\n\r\nWe are dedicated to recruiting candidates who consistently exceed our customers’ expectations.\r\n\r\nWe provide equal employment opportunity for all applicants and employees regardless of race, color, sex, gender identity, gender expression, religion, age, national origin, citizenship, disability, medical condition, family care status, marital status, domestic partner status, sexual orientation, genetic information, military/veteran status, or any other protected basis.