Public Consulting Group

Healthcare Organizational Operations Administrator

Job Locations US-NY-Albany
Posted Date 7 days ago(5/26/2023 11:44 AM)
Job ID
2023-9294
# of Openings
0
Category
Customer Service/Support
Type
Regular Full-Time
Practice Area
Staffing Solutions Organization

Overview

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.

 

Responsibilities

Healthcare Organizational Operations Administrator – Bureau of Medical Review in Menands, NY

Item 1470

 

The Division of Operations and Systems, Bureau of Medical Review is recruiting for a Healthcare Organizational Operations Administrator to assist the Bureau in day-to-day operations for the Center of Operational Excellence.  The Bureau of Medical Review is responsible for prior approval and pre-payment review of medical equipment and service, policy development as well as fraud and abuse monitoring for the New York State Medicaid System. The Center of Excellence is an initiative focusing on process improvement resulting in cost savings and staff efficiencies.

 

Duties include:

  • Review medical claims according to written procedures
  • Answer routine phone calls about claims review activities
  • Escalate issues & complex claims
  • Maintain a positive, professional demeanor always
  • All other activities as may be deemed necessary

Qualifications

Basic Qualifications:

  • High School graduate or equivalent
  • 3 years of administrative experience
  • Must be a United States Citizen or a Permanent Resident of the United States in order to be considered 

Preferred Qualifications:

  • Proficient in the use of standard office technology
  • Excellent organizational skills including the ability to prioritize work assignments
  • Ability to be flexible, innovative, and work in a team environment
  • Insurance claim experience
  • The understanding of an EOMB (explanation of medical benefits)

 

*Employees must follow established work schedules. The usual work schedule is 37.5 hours per week, Monday through Friday. Normal work hours are 8:00 a.m. to 4:30 p.m. unless otherwise specified by the supervisor, this includes a half hour unpaid lunch break. Total work hours must equal 37.5 hours per week.

Compensation

Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides the following reasonable range of compensation for this role: $17.00 hr. - $20.00 hr. In addition, SSO provides a range of benefits for this role.

EEO Statement

Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.

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