Medical Asstnce Specialist 1

Grade 18

New York State has approximately 161 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. Medical Asstnce Specialist 1

    Grade 18

  2. Medical Asstnce Specialist 2

    Grade 23

  3. Medical Asstnce Specialist 3

    Grade 27

  4. Medical Asstnce Specialist 4

    Grade 64

Summary of Job Description

As a Medical Assistance Specialist 1, you would be assigned duties related to the administration of Medicaid or other public health insurance programs. You would provide technical assistance to stakeholders in developing operational procedures, instructions, and guidelines to support the implementation of enrollment and eligibility activities, and ensure operational compliance; review and assist in implementing policy and regulatory changes; review training materials; review eligibility determinations for appropriateness; perform program reviews of Medicaid providers, demonstration projects, and automated systems; and assist in the preparation and evaluation of requests for proposals related to public health insurance programs.

View the classification standard for this title, on the Classification and Compensation webpage.

The NYS Title and Salary Plan provides additional information regarding other titles. 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, you must have six years of professional experience performing one or more of the following activities in a health care facility, health care agency, health care delivery system, Medicaid program, and/or other public or private health insurance program:


1) Establishing, revising, and/or assisting with the implementation of program policies and procedures to meet treatment and/or regulatory requirements of health care.

2)Analyzing State and/or federal health insurance laws to inform the development or modification of program operations.

3)Determining financial eligibility for enrollment in public or private health insurance plans or government funded health services programs. Experience must have included evaluation of individuals’ financial information and/or health condition to ensure individuals meet eligibility criteria specified in State and/or federal laws, rules, and regulations.

4)Establishing mechanisms for the reimbursement and financing of health care services, including rate-setting, development of capitation reimbursement methodologies, and development of fee schedules.

5)Performing utilization review of requests for medical treatment including prior approval or authorization activities, adjudication of claims for payment and/or provider credentialing.

6)Conducting independent examinations of health care facilities or program integrity reviews of health care programs to ensure compliance with laws, rules, and regulations. Experience may include observation, inspection and/or investigation activities as part of a health care accreditation, surveillance or audit team.

Substitution: An associate's degree may be substituted for up to two (2) years of the required general experience, OR a bachelor’s degree may be substituted for up to four (4) years of the required general experience. You must clearly indicate how you meet the remaining years of required experience.

Examples of non-qualifying experience: First level call center representatives, case managers, support service providers, patient programming coordinators, direct care experience, clerical and data entry duties, employee benefits, experience in a private physician’s office, experience as a billing clerk, or patient advocates. Typical advocacy activities involve patient rights, matters of privacy, confidentiality or informed consent, patient representation, awareness building, and support and education of patients, survivors, and their peers.

Qualifying health care or medical settings include: Facilities or entities licensed or regulated by a state government organization; facilities for individuals with mental or developmental disabilities, as defined by New York State Mental Hygiene Law; health care facilities under the jurisdiction of the federal government (including Veterans’ Affairs/military hospitals); or entities involved in the regulation or accreditation of health care facilities or agencies (including state departments of health, Centers for Medicare & Medicaid Services, and the Joint Commission).

A health care delivery system for the purposes of this examination includes general or governmental hospitals and hospital clinics; nursing homes; diagnostic and treatment centers; licensed ambulatory surgery centers; assisted living facilities; adult care residential facilities; rehabilitation facilities; intermediate care facilities for individuals with developmental disabilities; hospice agencies and units; home health care agencies; end stage renal disease clinics; health maintenance organizations; community-based home care programs; and psychiatric hospitals.

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.


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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