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Auditor

Location : Albany, NY
Job Type : Temp/Contract
Reference Code : AS3-DOH-380
Start Date : 02/24/2020
End Date : 04/17/2020
Hours : Full Time
Travel : No
Relocation : No

Job Description :

2 Auditors:    Office of Minority Health & Health Disparities-American Indian Health Program


Duties:


·         Analyze and review submitted medical claims for accuracy and conformance to procedural standards, and determine appropriate reimbursement to medical providers;


·         Assist in preparation of periodic reports and analysis;


·         Assist in the implementation and maintenance of policies and procedures related to control and processing of payment requests;


·         Manage the Unit's work flow, troubleshoot and report to supervisor when necessary;


·         Respond to inquiries from providers and Nation billing clerks.




1 Auditor:    Bureau of Administration-American Indian Health Program 


Duties:


·         Analyze and review submitted medical claims for accuracy and conformance to procedural standards, and determine appropriate reimbursement;


·         Assist in preparation of periodic reports and analysis;


·         Assist in the implementation and maintenance of policies and procedures related to control and processing of payment requests;


·         Manage the Unit's work flow, troubleshoot and report to supervisor when necessary;


·         Respond to inquiries from providers and Nation billing clerks.




1 Auditor:  Finance and Contract Management Unit


Duties:


·         Enter contractor line item budgets, budget modifications and quarterly expenses into the BOA Excel fiscal system for tracking of expenditures; notify BOA contract managers of any issues or errors encountered. 


·         Create contract requisitions in Statewide Financial System (SFS) for Division of Family Health (DFH) contracts moving through DOH for signature.


·         Correspond with contract providers notifying them of claim adjustments or to obtain corrections to claims submitted to ensure expenditure information is accurately entered into BOA Excel fiscal system.


·         Manage workflow of claims received, enter claim information into bureau voucher tracking system, advise contract managers of any issues encountered while processing claims in SFS to ensure payments are made to vendors in a timely manner.


·         Respond to inquiries from Dept of Health (DOH) management staff as well as contract providers regarding payments and claims status.




1 Auditor:  Office of Medical Director


Duties:


·         Develop SAS code to identify pregnancy-associated maternal deaths using available datasets, including vital records birth and death files, and hospital discharge files;


·         Link datasets and develop algorithms to identify cases of maternal mortality;


·         Perform data management using SAS;


·         Conduct analyses, assist with interpretation of the data, and prepare slides for presentations;


·         Evaluate quality of data;


·         Assist in data collection;


·         Conduct literature reviews;


·         Assist in writing reports.




1 Auditor: Enough is Enough


Duties:


·         Assist with contract monitoring by tracking submission of required documents, including quarterly reports, annual reports, applications, and requested contract amendment and extension documents.


·         Work with Enough is Enough Program and Sexual Assault Forensic Examiner (SAFE) Program Managers to coordinate communication with contractors and applicants.


·         Conduct initial review of fiscal documents submitted by Enough is Enough contractors, including budgets and budget modifications and work with Program Managers to coordinate communication with contractors.


·         Conduct quarterly audit of SAFE Program reports to identify program needs, data submission issues, and necessary corrections to improve data quality.  Work with SAFE Program Managers to review deficiencies identified and coordinate communication with providers.


·         Monitor Enough is Enough and Rape Crisis Program shared mailbox for contractor and applicant submissions. 


·         Assist with data entry and other tasks as needed. 














Required Qualifications :

2 Auditors:    Office of Minority Health & Health Disparities-American Indian Health Program


Skills required:


·         General/Basic Understanding of the medical claims’ submission process, which includes analyzing Explanation of Benefits (EOB) forms to interpret payment information, ability to read and interpret Medicaid billing schedules and policies, as well as Current Procedural Terminology (CPTs) and Healthcare Common Procedural Coding System (HCPCS);


·         General knowledge of automated accounting systems;


·         Ability to analyze data and apply basic Generally Accepted Accounting Principles (GAAP) when necessary;


·         Proficiency in Microsoft Excel and Word programs;


·         Good written and oral communication skills, as well as good organizational skills.


 


Preferred Skills:


·         1+ years’ work experience as a Medical Coder, Billing Specialist, or equivalent.




1 Auditor:    Bureau of Administration-American Indian Health Program 


Skills required: 


·         Understanding and ability to read and interpret Medicaid billing schedules and policies;


·         General knowledge of automated accounting systems;


·         Ability to analyze data and apply basic Generally Accepted Accounting Principles (GAAP) when necessary; Proficiency in Microsoft Excel and Word programs;


·         Good written and oral communication skills, as well as good organizational skills.




1 Auditor:  Finance and Contract Management Unit


 


Skills required:


 


·         General knowledge of automated accounting systems.


 


·         Ability to analyze data and apply basic Generally Accepted Accounting Principles (GAAP) when necessary.


 


·         Proficiency in Microsoft Excel and Word programs.


 


·         Good written and oral communication skills, as well as good organizational skills.


 


Additional skill preferred:


 


·         Have a strong knowledge of the NYS Statewide Financial System; how to enter claims, processes credit memos and create contract requisitions.




1 Auditor:  Office of Medical Director


 


Skills required:


 


·         Proficient programmer in SAS or other statistical software as demonstrated by minimum one-year full time or two-year part time work experience in an environment where SAS/other software is used


 


·         Experience with large database management in SAS or any other statistical software – minimum one year fulltime or two-year part time work experience in an environment with large databases


 


·         Proficient at handling various types of data files including text, SAS, Access, Excel files


 


·         Data analysis experience – one year fulltime or two years part-time demonstrated by acknowledgement in a report or publication


 


·         Experience working with confidential data


 


·         Data entry experience preferably in Access forms


 


·         Master’s degree or 36 credits of graduate-level coursework in Biostatistics, Epidemiology or a related -field




1 Auditor: Enough is Enough


Skills Required:


·         Proficiency in Microsoft Outlook, Excel, and Word programs.  Familiarity with PowerPoint and Access.


·         Good written and oral communication skills, as well as good organizational skills and attention to detail.


Additional Skills Preferred:


·         Prior knowledge of NYS agency systems and processes.


·         Experience collecting, analyzing and summarizing data. 












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