Promotion Examination Open To All Qualified Employees of the New York State Department of Health

Medicaid Claims Examiner 2/3/4

* Due to the size of the candidate population for this test date, you may be assigned to either Saturday, January 24, 2015, or Sunday, January 25, 2015, to take your test. Your admission notice will tell you where and when you are scheduled to appear. You cannot request a day or time in advance or change your scheduled day or time.

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Minimum Qualifications

On or before January 24, 2015, you must be a qualified employee of the New York State Department of Health and have had three months of permanent competitive or 55-b/55-c service as follows:

For No. 37-287:

Either A. Agency Services Representative;

Or B. in a title allocated to G-9 or higher.

For No. 37-288:

Either A. as a Medicaid Claims Examiner 2;

Or B. one year in a title allocated to a G-9 or higher.

For No. 37-289:

Either A. as a Medicaid Claims Examiner 3;

Or B. as a Medical Assistance Specialist 1, or one year as a Medicaid Claims Examiner 2.

If you were permanently appointed to a qualifying title on or before October 24, 2014, and have served continuously in this title since that date, you are eligible to file for this examination.

Qualifying Experience for Appointment from the Eligible List

Successful candidates will be qualified for appointment from the eligible list as follows:

For No. 37-287: After one year of the service described in the Minimum Qualifications, successful candidates will be qualified for appointment from the eligible list.

For No. 37-288:

Either 1. after one year as a Medicaid Claims Examiner 2;

Or 2. after two years of service in a title allocated to a G-9 or higher.

For No. 37-289:

Either 1. after one year as a Medicaid Claims Examiner 3;

Or 2. after one year as a Medical Assistance Specialist 1, or after two years as a Medicaid Claims Examiner 2.

Important: As the processing fee is non-refundable, verify that you entered the correct examination number and title on your online or paper application prior to submitting. If you apply online, you should immediately review your email confirmation notice to verify that you applied for the correct examination. If you do not receive a confirmation number after submitting your online application, your application was NOT received by the Department of Civil Service. No late applications will be accepted after the filing deadline has passed.

Order of Certification

The order of certification of this eligible list will be:

1. "A" eligibles
2. "All" eligibles

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Subject of Examination

There will be a written test which you must pass in order to be considered for appointment. The written test is designed to test for knowledge, skills, and/or abilities in such areas as:	For Examination Numbers
	37-287	37-288	37-289
1. Concepts, terms, laws, policies and procedures related to Medicaid - These questions test for knowledge of concepts, terms, laws, policies and procedures related to Medicaid. Question topics may include, but are not limited to, eligibility, benefits, client services, provider services, programs, fee schedules, coding, terminology, and computer systems.	X	X	X
2. Preparing written material - These questions test for the ability to present information clearly and accurately, and to organize paragraphs logically and comprehensibly. For some questions, you will be given information in two or three sentences followed by four restatements of the information. You must then choose the best version. For other questions, you will be given paragraphs with their sentences out of order. You must then choose, from four suggestions, the best order for the sentences.	X	X	X
3. Supervision - These questions test for knowledge of the principles and practices employed in planning, organizing, and controlling the activities of a work unit toward predetermined objectives. The concepts covered, usually in a situational question format, include such topics as assigning and reviewing work; evaluating performance; maintaining work standards; motivating and developing subordinates; implementing procedural change; increasing efficiency; and dealing with problems of absenteeism, morale, and discipline.	X	X
4. Understanding and interpreting written material - These questions test how well you comprehend written material. You will be provided with brief reading selections and will be asked questions about the selections. All the information required to answer the questions will be presented in the selections; you will not be required to have any special knowledge relating to the subject areas of the selections.	X	X
5. Ensuring effective inter/intra agency communications - These questions test for understanding of techniques for interacting effectively with individuals and agencies, to educate and inform them about topics of concern, to clarify agency programs or policies, to negotiate conflicts or resolve complaints, and to represent one's agency or program in a manner in keeping with good public relations practices. Questions may also cover interacting with the staff of one's own agency and/or that of other agencies in cooperative efforts of public outreach or service.	X	X
6. Preparing reports and official documents - These questions test for the ability to prepare reports and other official documents for use within and among governmental agencies, in legal or regulatory settings, or for dissemination to the public. Some questions test for a knowledge of correct grammar, usage, punctuation, and sentence structure. Others test for the ability to use the proper tone and to express information clearly and accurately.			X
7. Administrative supervision - These questions test for knowledge of the principles and practices involved in directing the activities of a large subordinate staff, including subordinate supervisors. Questions relate to the personal interactions between an upper level supervisor and his/her subordinate supervisors in the accomplishment of objectives. These questions cover such areas as assigning work to and coordinating the activities of several units, establishing and guiding staff development programs, evaluating the performance of subordinate supervisors, and maintaining relationships with other organizational sections.			X
8. Administrative techniques and practices - These questions test for a knowledge of management techniques and practices used in directing or assisting in directing a program component or an organizational segment. Questions cover such areas as interpreting policies, making decisions based on the context of the position in the organization, coordinating programs or projects, communicating with employees or the public, planning employee training, and researching and evaluating areas of concern.			X

If you pass, your seniority credit(s), if any, will be included in the computation of your final score. Rank on the eligible list will be determined after adding any wartime veterans' credits to your final passing score.

Credit for Seniority

Seniority is credited at the rate of one credit for each five-year period (or fraction thereof), excluding the first year of service.

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Duties

As a Medicaid Claims Examiner 2, you would perform duties related to the review of claims for payment for health care services provided under the New York State Medical Assistance (Medicaid) Program and the enrollment and participation of both fee for-service practitioners and institutional health care providers in the Medicaid Program. You would supervise subordinate staff in the performance of adjudication and processing of claims for payment, health care provider enrollment in Medicaid, and issues of participation and payment of providers in the Medicaid Program.

As a Medicaid Claims Examiner 3, in addition to the duties above, you would supervise Medicaid Claims Examiners 2; handle non routine claims and involved provider issues; ensure the consistent application of payment and pricing policy and guidelines; and oversee the review and processing of new provider enrollment requests.

As a Medicaid Claims Examiner 4, in addition to the duties above, you would serve as a manager, usually of multiple units, and supervise positions of Medicaid Claims Examiner 3. You would address provider groups and professional organizations and represent the Medicaid program in State and federal audits and program reviews. You would provide input into payment policy development and editing enhancements, while making determinations regarding significant cases and claims that are unable to be resolved at a lower level.

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How To Apply

If you do not receive a confirmation number after submitting your online application, your application was NOT processed.

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.

Religious Accommodation

Most written tests are held on Saturdays. If you cannot take the test on the announced test date, due to a conflict with a religious observance or practice, check the box under “Religious Accommodation.” We will make arrangements for you to take the test on a different date (usually the following day).

Reasonable Accommodations in Testing

It is the policy of the Department of Civil Service, in accordance with the New York State Human Rights Law and the Americans with Disabilities Act, to provide qualified persons with disabilities equal employment opportunity and equal opportunity to participate in and receive the benefits, services, programs, and activities of the Department. It is the policy of the Department to provide such persons reasonable accommodations and reasonable modifications as are necessary to provide equal opportunity. Persons with disabilities who require an accommodation to participate in an examination must note this on their application. Further information is available from the Test Administration Unit of the Department of Civil Service. In the Albany area, call 518-457-2487 [press 2, then press 2]. Outside of the Albany area, call toll free at 1-877-697-5627 [press 2, then press 2]. For TDD services, call NY Relay at 711 (requires a fee) or 1-800-662-1220.

Admission to Examination

Notice to appear for the test may be conditional as review of applications may not be made until after the test. If you have not received your notice to appear for the written test three days before the date of the test, call 518-474-6470 in the Albany area or toll free at 1-877-697-5627 [press 2, then press 1].

Multiple Examinations Scheduled for the Same Day

If you have applied to take a written test announced by either one or several local jurisdictions (county, town, city) scheduled to be held on the same test date as this written test, you must notify each of the local jurisdictions no later than two weeks before the test date to make arrangements for taking all tests at one test site. All tests will be held at the state examination center. For your convenience, contact information for all local civil service agencies is available on our website at: http://www.cs.ny.gov/jobseeker/local.cfm

Eligibility for Examination

To be eligible to compete in this examination, you must be employed in the specified department or agency on a permanent or contingent permanent basis in the competitive class, or in the non-competitive class or labor class if specifically noted on this announcement (or be on an appropriate preferred list), and have the specified time in the specified title or salary grade. You may not compete in a test for a title if you are permanently employed in that title (unless you are still on probation) or in a higher direct line of promotion.

Cell Phones or Electronic/Communication Devices at the Test Site

Do not bring cell phones, beepers, headphones, or any electronic or other communication devices to the test site. The use of such devices at the test site in the test room, hallways, restrooms, building, grounds, or other areas could result in your disqualification.

S1/TC1 HXC-vla
Issued: 11/7/14

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.

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