You are on page 1of 3

New York State Department of Civil Service Announces Open-

Competitive Examination Open to the Public

Medicaid Eligibility Examiner 2
Evaluation of Training and Experience To Be Held During
April 2015
Applications Must Be Submitted or Postmarked By
March 04, 2015
Minimum Qualifications
Subject of Examination
How to Apply

Exams Included on This Announcement




Medicaid Eligibility Examiner 2







Appointees who work in the five boroughs of New York City or in Nassau, Suffolk, Rockland, or Westchester Counties
will receive an additional $3,026 annual downstate adjustment. Appointees who work in Dutchess, Orange, or Putnam
Counties will receive an additional $1,513 annual mid-Hudson adjustment.
Back To Top

Minimum Qualifications
On or before April 30, 2015, you must have four years of full time experience performing at least one of the six
activities listed below in any of the following programs that: provides reimbursements for health care services; works
with social services program areas; determines eligibility for a consumer assisted program in a hospital or other health
care facility; provides health care regulatory oversight; or performs quality assurance and interpretation/application of
standards of health care.
Either 1. determining eligibility for a health care or consumer assisted program in which financial eligibility criteria
must be met;
Or 2. performing utilization review, including pre-payment or post-payment review of requested health care services,
prior approval or authorization activities, adjudication or pricing of claims for payment; or analysis of patterns of health
Or 3. determining reimbursement and financing of health care services, including rate-setting or approval, establishing
capitation reimbursement methodologies, assessing fee schedules, coding constructs for medical goods and services,

or applying/processing of reimbursement methodologies;

Or 4. performing quality assurance activities such as ensuring compliance with laws, rules, regulations, and policies;
Or 5. inspecting, assessing, or monitoring health care programs or facilities for certification, licensure or adherence to
laws, rules, regulations, and policies;
Or 6. planning, designing, developing, researching, or evaluating proposals to establish or refine programs, with
ongoing responsibility for interpreting legislation or regulations, defining/describing target populations and local
demographics, grant/proposal writing, or developing, reviewing, and evaluating contracts.
Substitution: College credit may be substituted for up to two years of the general experience at the rate of 30 college
credit hours equaling one year of experience. You must clearly demonstrate how you meet the remaining years of
For the purposes of this exam, qualifying experience settings may include, but are not limited to: local district social
services, hospitals or other healthcare facilities, health insurance companies, and health insurance call centers.
Non-qualifying experience includes patient advocates, case managers, direct care experience, clerical and data entry
duties, billing clerk, receptionist or scheduler in a physicians office or hospital.

1. There is no processing fee for this exam.
2. Applications must be mailed directly to the NYS Department of Health; see Where To Apply.
3. Your degree or college credit must have been awarded by a regionally accredited college or university or one
recognized by the NYS Education Department as following acceptable educational practices. If your degree or
college credit was awarded by an educational institution outside the United States and its territories, you must
provide independent verification of equivalency. You can write to the Examination Information Desk of the NYS
Department of Civil Service for a list of acceptable companies who provide this service. You must pay the
required evaluation fee
4. If you meet the Minimum Qualifications you may also be interested in competing in Examination No. 80-195,
Medicaid Eligibility Examiner 3 and Examination No. 80-196 Medicaid Eligibility Examiner 4.
5. Appropriate part-time and volunteer experience, which can be verified, will be accepted on a prorated basis.
6. New York State residence is not required.

These positions exist in the New York State Department of Health.
Back To Top

As a Medicaid Eligibility Examiner 2, you would supervise subordinate staff and perform duties related to the New
York State Medicaid Program and other public health insurance programs within the Department of Health. You would
plan and conduct staff training in response to revised regulations or procedures, schedule work and monitor workload
as well as quality assurance of work completed by staff. You would develop and review eligibility scenarios to test new
computer applications and systems. You would process basic and more complex eligibility applications and address
specific concerns for resolution of more complex applications that require interpretation of policies and procedures or
additional investigation.
Back To Top

Subject of Examination
There will be no written test. The test will consist of an evaluation of your education and experience. When you
apply, you must provide complete information to show that you meet the minimum qualifications. Do NOT send
resumes. If you apply using the NYS-APP form and you need more space, attach additional 8" x 11" sheets
following the same format used on the application form. Additional unsolicited information will not be accepted after
the last date for filing.

If you meet the Minimum Qualifications you will be sent a supplemental questionnaire to complete and return to the
NYS Department of Health. The questionnaire will be used to evaluate the level, length, and relevance of your
education and experience against the general background/critical activities of the position. This questionnaire will be
the only basis for rating your education and experience.
Your final score must be 70 or higher in order to pass. Rank on the eligible list will be determined after adding any
wartime veterans' and Civil Service Law Section 85-a credits to your final passing score.

How to Apply
Download examination application NYS-APP form; or
Email to request NYS-APP forms; or
Obtain an NYS-APP form from a State agency or facility personnel/business office; or
Request NYS-APP form by calling the Department of Civil Service in Albany at 518-457-2487 [press 2, then
press 3] or toll free at 1-877-697-5627 [press 2, then press 3].

Where to Apply
Mail your completed application to:
New York State Department of Health, Bureau of Personnel Management, Corning Tower, Room 2217,
Albany, New York 12237.

Additional Information
New York State is an Equal Opportunity Employer
It is the policy of the State of New York to provide for and promote equal opportunity employment, compensation, and
other terms and conditions of employment without discrimination on the basis of age, race, color, religion, disability,
national origin, gender, sexual orientation, veteran or military service member status, marital status, domestic violence
victim status, genetic predisposition or carrier status, or arrest and/or criminal conviction record unless based upon a
bona fide occupational qualification or other exception.
Appointment to many positions in State government require candidates to undergo an investigative screening. This
may include a thorough character investigation, a Federal Bureau of Investigation Criminal Record History Check, a
Child Abuse Registry clearance, or other similar procedures. Candidates may be fingerprinted and may be required to
pay any necessary fees for that procedure. Depending on the nature of the job, the criminal convictions discovered, or
any falsified or omitted information revealed, the investigative findings may bar appointment or result in removal after
Eligibility for Employment
You must be legally eligible to work in the United States at the time of appointment and throughout your employment
with New York State. If appointed, you must produce documents that establish your identity and eligibility to work in
the United States, as required by the federal Immigration Reform and Control Act of 1986, and the Immigration and
Nationality Act.
Issued: 1/30/2015
This announcement is subject to amendment or cancellation without notice. Do not copy it, or post it to any other site,
but link to it instead.
Back To Top