MEDICAID ELIGIBILITY VERIFICATION SPECIALIST
Agency HRA/DEPT OF SOCIAL SERVICES —Manhattan, NY
- $61,656 - $70,904 a year
- Full-time
- High school
- Data analysis skills
- Mid-level
- Loan forgiveness
- Food provided
Telephone Representative II (Provider Relations)
1199SEIU Family of Funds —New York, NY
- $49,940.28 a year
- Full-time
- Research
- Mid-level
- High school diploma or GED
- Vision insurance
Payer Enrollment Coord II
University of Rochester —Albany, NY
- $19.04 - $26.63 an hour
- Full-time
- Remote
- Mid-level
- EMR systems
- 1 year
Quality Control Reviewer III
1199SEIU Family of Funds —New York, NY
- $50,741.60 - $64,145.64 a year
- Full-time
- Mid-level
- High school diploma or GED
- Analysis skills
ELIGIBILITY AND SUPPORT SERVICES COORDINATOR
HRA/DEPT OF SOCIAL SERVICES —Bronx, NY
- $68,209 - $78,440 a year
- Full-time
- High school
- Mid-level
- Office
- Employee assistance program
- Loan forgiveness
10d
Medicaid Eligibility/Authorization Coordinator Sunshine Homecare Services
Sunshine Homecare Services Corp —New City, NY
- $26.44 - $31.25 an hour
- Full-time
- Mid-level
- 3 years
- Bachelor's degree
- Health insurance
- Dental insurance
Quick Apply
Eligibility Service Representative - Russian Speaking
Brighton Health Plan Solutions, LLC —New York, NY
- $43,000 - $50,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Computer literacy
- Health insurance
- Vision insurance
Quick Apply
12d
Customer Service Representative - Call Center
SUNY College of Optometry —New York, NY
- $49,373 a year
- Full-time
- Bilingual
- Microsoft Excel
- Microsoft Outlook
- Paid holidays
- Loan forgiveness
Quick Apply
10d
Senior Attorney/Assistant Attorney 1/2/3 (NY HELPS) WCB Item #2265
State of New York - Workers' Compensation Board —Brooklyn, NY
- $66,951 - $125,413 a year
- Email
- Hybrid work
- Background check
- Bachelor's degree
- Military encouraged
- Paid parental leave
- Paid holidays
2d
Enrollment Supervisor
ADMIN FOR CHILDREN'S SVCS —Manhattan, NY
- $62,868 - $97,593 a year
- Full-time
- Management
- Mid-level
- Office
- Loan forgiveness
4d
Assistant Director Leaves Administration and Benefits
Episcopal Health Services —Garden City, NY
- $120,000 - $135,000 a year
- Full-time
- Google Workspace
- 6 years
- Office
- Dental insurance
- Parental leave
Quick Apply
Data and Compliance Coordinator (Education and Workforce)
GODDARD RIVERSIDE COMMUNITY CENTER —New York, NY
- $58,000 - $65,000 a year
- Weekends as needed
- Mid-level
- Bachelor's degree
- Children
Quick Apply
Repayee/Housing Coordinator
Beyond Support Network —Buffalo, NY
- $25 an hour
- Experience working with individuals with disabilities
- Mid-level
- Finance
Quick Apply
Children's Care Manager
Association For Mental Health And Wellness —Ronkonkoma, NY
- $50,000 - $52,000 a year
- Weekends as needed
- Background check
- Spanish
- Microsoft Excel
- Mileage reimbursement
- Paid holidays
Quick Apply
Senior Assistant Director of Admission
Bard College —Annandale-on-Hudson, NY
- $65,000 - $70,000 a year
- Weekends as needed
- Hybrid work
- Writing skills
- Public speaking
- Mid-level
- Health insurance
- Retirement plan
Home Care Marketer
ROYAL CARE INC. —New York, NY
- $50,000 - $80,000 a year
- Full-time
- Bilingual
- Spanish
- Sales
- Health insurance
- Dental insurance
Quick Apply
Fee for Service Children's Care Manager
Association For Mental Health And Wellness —Ronkonkoma, NY
- $30 - $42 an hour
- Part-time
- Bilingual
- Microsoft Word
- Background check
- 403(b)
- Paid sick time
Quick Apply
Business Development Representative / Home Care Marketer
ROYAL CARE INC. —New York, NY
- $50,000 - $80,000 a year
- Full-time
- Bilingual
- Spanish
- Sales
- Health insurance
- Dental insurance
Quick Apply
Care Manager
ABBOTT HOUSE —Irvington, NY
- $41,567 - $50,818 a year
- Full-time
- Experience working with individuals with developmental disabilities
- Nursing
- Clean driving record
- Vision insurance
Quick Apply
Customer Service Representative
JP McHale Pest Management, LLC —Buchanan, NY
- From $21 an hour
- Full-time
- Computer literacy
- Microsoft Office
- Data entry
- Paid holidays
- Health insurance
Quick Apply

I want to receive the latest job alert for enrollment and eligibility representative in new york state

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

enrollment and eligibility representative jobs near new york state

Care Manager jobs in Ronkonkoma, NY

Support Coordinator jobs in Bronx, NY

Business Development Representative jobs in New York, NY

Eligibility Specialist jobs in Manhattan, NY

Quality Control Associate jobs in New York, NY

Telephone Representative jobs in New York, NY

Customer Service Representative jobs in New York, NY

Compliance Officer jobs in New York, NY

Enrollment Eligibility Representative jobs in New York, NY

Service Coordinator jobs in Erie, PA

Service Coordinator jobs in Pelham, AL

Remote Coordinator jobs in San Diego, CA

Work From Home Customer Service jobs in Raleigh, NC

Service Coordinator jobs in Kennesaw, GA

Service Coordinator jobs in Flint, MI

Supply Chain Manager jobs in Minneapolis, MN

Care Manager jobs in Wisconsin

Care Manager jobs in Albuquerque, NM

Part Time Child Care jobs in Nashville, TN

Care Manager jobs in Quincy, IL

MEDICAID ELIGIBILITY VERIFICATION SPECIALIST

Agency HRA/DEPT OF SOCIAL SERVICES
Manhattan, NY

Apply Now

Job Details

Full-time
$61,656 - $70,904 a year

Benefits

Loan forgiveness
Food provided

Qualifications

Administrative experience
Supervising experience
Clerical experience

Full Job Description

MEDICAID ELIGIBILITY VERIFICATION SPECIALIST

HRA/DEPT OF SOCIAL SERVICES

Posted on

06/25/2026

Full-time

Location

MANHATTAN

Exam may be required

Department

Revenue Mgmt/Development-NM

Salary range: $61,656.00 – $70,904.00

Save

Job Description

APPLICANTS MUST BE PERMANENT IN THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE

The Department of Social Services (DSS) is comprised of the administrative units of the New York City Human Resources Administration (HRA) and the Department of Homeless Services (DHS). HRA is dedicated to fighting poverty and income inequality by providing New Yorkers in need with essential benefits such as Food Assistance and Emergency Rental Assistance. DHS is committed to preventing and addressing homelessness in New York City by employing a variety of innovative strategies to help families and individuals successfully exit shelter and return to self-sufficiency as quickly as possible.

The Bureau of Case Integrity & Eligibility Verification’s mission is to maximize revenue generation for DSS/HRA/DHS and outside Agencies, ensure payments are categorically eligible for their respective funding streams and carry out cost avoidance projects to minimize audit disallowances.

The Office of Revenue Management and Development (ORMD) is requesting a Principal Administrative Associate II position to function as a Medicaid Eligibility Verification Specialist in its Bureau of Case Integrity and Eligibility Verification (BCIEV)/ Eligibility Verification Unit, who will:

Review and analyze Medicaid Assistance case records and computer data to determine which cases qualify for a category that is eligible for State and Federal funding. Identify retroactive obligations that have not been claimed and to determine the effective date of adjustment for Federal and State reimbursements as established by case record entries and date of change and occurrence.

Review of Medicaid/Family Health Plus enrollees assigned more than one Client Identification Number (CIN) and subsequently enrolled into a Managed Care Organization (MCO) under different CINs as identified by New York Office of Medicaid Inspector General (OMIG). Follow OMIG’s specific instructions and timeframe to return the file. Also, prepare Turnaround Documents (TADS) for demographic (changes to improve the quality of clearance matches and to help prevent duplicate CIN assignments in the future.

Review of Medicaid/Family Health Plus enrollees assigned more than one Client Identification Number (CIN) and subsequently enrolled into a Managed Care Organization (MCO) under different CINs as identified by Office of New York State Comptroller (OSC). Follow OCS’ specific instructions and timeframe to return the file. Also, prepare Turnaround Documents (TADS) for demographic changes to improve the quality of clearance matches and to help prevent duplicate CIN assignments in the future.

Review of Medicaid (MA) recipients identified, by Finance Office through systems match, as having multiple active Client Identification Number (CIN) in an effort to end individuals’ enrollment in multiple Medicaid Managed Care plans. Prepare reports to share with MAP of which CIN should be disenrolled from Managed Care. Also prepare Turnaround Documents (TADS) for changes to improve the quality of clearance matches and to help prevent duplicate CIN assignments in the future. Adhere to tight claim deadlines.

Review Invalid Social Security Number Validation files of Medicaid Assistance an invalid Social Security Numbers to assist with minimizing audit disallowances and minimizing fraud. Verify clients’ demographics and prepare Turnaround Documents (TADS), when applicable, to correct client demographics. Prepare reports of referrals to Investigation, Revenue and Enforcement Administration (IREA) for client call-in and suspected fraud cases.

Keep abreast of current Federal, State and Agency policy and procedures to ensure categorical eligible payments adhere to all appropriate regulatory requirements. Assess the potential impact on claims and claim adjustments the requirements governing the various funding streams to ensure BCIEV is current and in compliance with existing funding requirements.

Perform quality assurance for Enterprise Data Warehouse (EDW) and Medicaid Data Warehouse (MDW) queries testing and providing feedback to enhance EDW queries.

Complete manual case lookups in response to Medicaid related press inquiries, FOIL requests, and DSS/DHS/HRA Senior staff requests, when data match results are inconclusive, to provide accurate details, case category and eligibility.

Perform case review analysis of Agency audit findings of cases potentially claimed in an incorrect category.

Work on numerous special projects involving other areas of the agency

Provide back-up documentation to substantiate claims and claim adjustments submitted by Finance Office/ORMD units

Create case records utilizing screenshots from Welfare Management System (WMS), HRA One Viewer, Systematic Alien Verification for Entitlements (SAVE), Electronic Medicaid of New York (eMedNY), Paperless Office System (POS) and other systems.

Work Location: 4 World Trade Center
Hours/Schedule: 9:00 am to 5:00 pm

PRINCIPAL ADMINISTRATIVE ASSOC - 10124

Minimum Qualifications

1. A baccalaureate degree from an accredited college and three years of satisfactory full-time progressively responsible clerical/administrative experience, one year of which must have been in an administrative capacity or supervising staff performing clerical/administrative work of more than moderate difficulty; or
2. An associate degree or 60 semester credits from an accredited college and four years of satisfactory full-time progressively responsible clerical/administrative experience including one year of the administrative supervisory experience described in "1" above; or
3. A four-year high school diploma or its educational equivalent approved by a State's department of education or a recognized accrediting organization and five years of satisfactory full-time progressively responsible clerical/administrative experience including one year of the administrative supervisory experience as described in "1" above;
4. Education and/or experience equivalent to "1", "2", or "3" above. However, all candidates must possess the one year of administrative or supervisory experience as described in "1" above. Education above the high school level may be substituted for the general clerical/administrative experience (but not for the one year of administrative or supervisory experience described in "1" above) at a rate of 30 semester credits from an accredited college for 6 months of experience up to a maximum of 3½ years.

Preferred Skills

Knowledge of Welfare Management System (WMS), Paperless Office System (POS), HRA One Viewer, and Electronic Medicaid of New York (eMedNY).

55a Program

This position is also open to qualified persons with a disability who are eligible for the 55-a Program. Please indicate at the top of your resume and cover letter that you would like to be considered for the position through the 55-a Program.

Public Service Loan Forgiveness

As a prospective employee of the City of New York, you may be eligible for federal loan forgiveness programs and state repayment assistance programs. For more information, please visit the U.S. Department of Education’s website at https://studentaid.gov/pslf/.

Residency Requirement

New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview.

Additional Information

The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected characteristic, including but not limited to an individual's sex, race, color, ethnicity, national origin, age, religion, disability, sexual orientation, veteran status, gender identity, or pregnancy.

Apply

Save

Job ID

777973

Posted until

08/24/2026

Title code

10124

Civil service title

PRINCIPAL ADMINISTRATIVE ASSOC

Title classification

Competitive-1

Business title

MEDICAID ELIGIBILITY VERIFICATION SPECIALIST

Experience level: Experienced (non-manager)

Job level

Number of positions

Work location

4 World Trade Center

Category: Administration & Human Resources

MEDICAID ELIGIBILITY VERIFICATION SPECIALIST

Apply Now

Refine Your Search

enrollment and eligibility representative jobs in new york state

MEDICAID ELIGIBILITY VERIFICATION SPECIALIST

Telephone Representative II (Provider Relations)

Payer Enrollment Coord II

Quality Control Reviewer III

ELIGIBILITY AND SUPPORT SERVICES COORDINATOR

Medicaid Eligibility/Authorization Coordinator Sunshine Homecare Services

Eligibility Service Representative - Russian Speaking

Customer Service Representative - Call Center

Senior Attorney/Assistant Attorney 1/2/3 (NY HELPS) WCB Item #2265

Enrollment Supervisor

Assistant Director Leaves Administration and Benefits

Data and Compliance Coordinator (Education and Workforce)

Repayee/Housing Coordinator

Children's Care Manager

Senior Assistant Director of Admission

Home Care Marketer

Fee for Service Children's Care Manager

Business Development Representative / Home Care Marketer

Care Manager

Customer Service Representative

I want to receive the latest job alert for enrollment and eligibility representative in new york state

Related Searches

Explore jobs in more locations

MEDICAID ELIGIBILITY VERIFICATION SPECIALIST

Job Description

Minimum Qualifications

Preferred Skills

55a Program

Public Service Loan Forgiveness

Residency Requirement

Additional Information

Job Seeker Tools

Employer Tools

Browse

Stay Connected