GOT-IT

Medicaid Claims Examiner 3

Grade 17

New York State has approximately 5 positions* in this title statewide. You may view a breakdown of positions by county. This position exists in Health, Department of. View links to all New York State agencies including agencies that have this title. For more information, New York State employees can contact the Career Mobility Office at (518) 485-6199 or (800) 553-1322. If you are not a current New York State employee, you can use the Department of Civil Service Web site to explore possible employment opportunities.

*The number of positions is approximate and represents the number of positions established (both filled and vacant); it is not an indication or reference to position type or duration, or intent to be filled. If you are viewing a trainee title, please note this number reflects the number of positions established at the journey level. Agencies may fill at the trainee level(s) or at the journey level based on employee qualifications. GOT-IT does not provide information on any job postings or job availability. For information on current job postings, please visit State Jobs NY. You may also visit specific New York State Agency websites for information about an agency and its job opportunities.

Career Ladder

A listing of titles that are most commonly used as steps for upward mobility for this title series. The salary schedule for this career ladder is also available.

  1. Medicaid Claims Examiner 2

    Grade 14

  2. Medicaid Claims Examiner 3

    Grade 17

  3. Medicaid Claims Examiner 4

    Grade 21

Summary of Job Description

You would perform duties related to the review of claims for payment for health care services provided under the New York State Medical Assistance (Medicaid) Program and the enrollment and participation of both fee for-service practitioners and institutional health care providers in the Medicaid Program. You would supervise subordinate staff in the performance of adjudication and processing of claims for payment, health care provider enrollment in Medicaid, and issues of participation and payment of providers in the Medicaid Program.

As a Medicaid Claims Examiner 3, in addition to the duties above, you would supervise Medicaid Claims Examiners 2; handle non routine claims and involved provider issues; ensure the consistent application of payment and pricing policy and guidelines; and oversee the review and processing of new provider enrollment requests.

There is no classification standard available at this time for this title. For additional information regarding other titles this will bring you to the NYS Title and Salary Plan. If there is a classification standard available there will be a link under the column labeled STD NO. If no link is available there is no classification standard available at this time for that title.

Summary of Minimum Qualifications

Please note: qualifications for this position may be subject to change. If substitutions for education and/or experience are allowed, this information would be available on the announcement.

You must take and pass a Civil Service examination in order to be considered for this position.

On or before the date of the examination, the candidate must be a qualified employee of the New York State Department of Health and have had three months of permanent competitive or 55-b/55-c service as either:

A. a Medicaid Claims Examiner 2;

OR

B. one year in a title allocated to a G-9 or higher.

For informational purposes only, click on the examination number(s) listed below to see the current or previous examination(s) that are used to fill this title.

37-287

How to Apply

When this examination is scheduled to be held, the announcement can be found on the Department of Civil Service, Examination Announcements web page. If you do not see an examination currently scheduled please check back on a monthly basis or sign up for announcement notification by email so that you will automatically be notified when new examinations are being offered.

Career Mobility

Career mobility is not just limited to the titles in the Career Ladder, above. Additional movement may be achieved through other examinations, additional education and/or work experience or transfer opportunities. For additional information or clarification of transfer determinations, current State employees should contact the Career Mobility Office. Visit ELMS Online to view established open-competitive, promotion, and transition eligible lists. If you are not a current New York State employee, see Employment Opportunities with New York State and find out how to become a New York State employee.

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