Duration: Long Term

　　Schedule: M - F : 9:00am - 5:00pm

　　Job Description:

　　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 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:

　　Division of Medical and Dental Directors

　　The Division of Medical and Dental Directors (DMDD) is responsible to support and further strengthen the ability to coordinate medical and dental policy direction across all aspects of Medicaid, including managed care, fee-for-service, and waiver programs.The DMDD Bureau of Medical Review performs Medicaid operational functions including prior authorization for durable medical equipment, medical supplies, private duty nursing services, hearing aids, and out-of-state hospital and skilled nursing facility admissions. The bureau is also responsible for the review and adjudication of Medicaid claims that pend for pricing, medical review, timeliness of submissions, and adherence to Medicaid claim submission policies. Additionally, the bureau operates a callThe Auditor positions are located within DMDD, Bureau of Medical Review Call Center and Administrative Staff Support unit. These positions have multiple responsibilities including, but not limited to:

　　Answering telephone inquiries from healthcare providers, members caregivers and advocacy groups related to prior approval of medical services such as durable medical equipment, medical supplies, hearing aids, private duty nursing and out of state inquiries involving nursing home placement and other out of state procedures.Escalating complex inquires that cannot be answered with available information to appropriate staffGuiding and educating providers, as well as members, on where to locate pertinent policy informationAssisting providers to troubleshoot our prior approval system(s).Performing data entry into excel spreadsheets and other tracking tools.Monitoring incoming emails and/or faxes from a shared mailbox and forward to the appropriate staff.Sending faxes through e-mail supported fax mailbox.Distributing fair hearing request and decisions to appropriate staff.Processing change request forms according to defined procedure.Supporting claims processing when other duties are finished.Maintaining a positive and professional demeanor always.All other activities as may be deemed necessary.Additional Skill Level, Experience or Other Requirements:

　　High School Graduate or EquivalentExperience with Microsoft Word and with Basic Excel functionsProficient in the use of standard office technology, to include fax machines, document scanners and copiersAbility to be flexible, innovative, and work in a team environmentAbout our Company: -

　　22nd Century Technologies, Inc., is one of the fastest growing IT Service Integrator and Workforce Solution companies in the United States. Founded in 1997, 22nd Century Technologies is a Certified National Minority Business Enterprise with 6,000+ people including 600+ Cyber SMEs nationwide supporting our customers in all 50 states, Canada, and Mexico. With HQs in Somerset, NJ and Mclean, VA, 22nd Century has 14 offices throughout the United States. As part of our unrelenting focus on quality and compliance, 22nd Century Technologies’ delivery is based on Certified Matured Processes including CMMI L3 Dev & SVC, ISO 20000, ISO 27001, and ISO 9001 quality processes. With a strong focus on the public sector, 22nd Century currently holds government contracts with 14 out of 15 Federal Executive agencies including DoD, 37 other Federal agencies, 50 States, 115+ Local agencies, and 37 School Districts. In the last three years, we have expanded our services to Fortune 500 and other commercial clients and currently support 80+ commercial clients.

　　Recognized among “Best Company to Work For” by Forbes, 22nd Century Technologies, Inc., consistently exceeds our clients’ expectations by focusing on their absolute satisfaction with jobs while keeping our employees motivated.

　　“22nd Century Technologies is an Equal Opportunity Employer" and “US Citizens & all other parties authorized to work in the US are encouraged to apply."

　　All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

　　Minimum Salary: 31200.00Maximum Salary: 31200.00Salary Unit: Yearly