New York State of Opportunity

New York State Department of Civil Service announces Continuous Recruitment Examination Open to All Qualified Individuals

Medical Care Representative

Applications Accepted
Tests To Be Held


Exams Included on This Announcement
Exam Number Exam Title Salary Grade Beginning Salary*
20-540 Medical Care Representative SG-19 $59,671


This examination is being held to fill positions at the State Insurance Fund, the Workers' Compensation Board, Office of the State Comptroller, Office of Victim Services, and the Department of Law (Office of the Attorney General).

Appointees who work in the five boroughs of New York City, or in Nassau or Suffolk County will receive an additional geographic pay differential of $5,579 added to the beginning salary. Appointees who work in Rockland or Westchester County will receive an additional geographic pay differential of $3,420 added to the beginning salary.

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.

NOTE: This examination is being conducted by the New York State Insurance Fund under authority delegated by the Department of Civil Service in compliance with the New York State Civil Service Law and the Rules and Regulations of the New York State Department of Civil Service.

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Minimum Qualifications

On or before the date of filing your application, you must have a current license, and be registered to practice as a registered professional nurse in New York State. In addition, you must have had three years of registered nursing experience in the following areas: rehabilitation, medical/surgical, public health, community health, visiting nursing, occupational health, utilization review, or review of medical records from hospitals for appropriate ICD9 or 10/DRG/PAS/CPT* coding.

*International Classification of Diseases - 9th or 10th Volume/Diagnostic Related Groups/Products of Ambulatory Surgery/Current Procedural Terminology.

Substitution: A Nurse Practitioner License in any of the areas listed above, or certification as a certified coder, may be substituted for one year of the qualifying experience.


  1. Continuous employment as a Medical Care Representative is dependent on acquisition of a permanent RN license. Loss of license will result in removal of employment.
  2. Appropriate part-time and volunteer experience, which can be verified, will be accepted on a prorated basis.
  3. If you are appointed, you may be required to possess a valid license to operate a motor vehicle in New York State or otherwise demonstrate your capacity to meet the transportation needs of the job. Field work travel expenses will be reimbursed on a fixed schedule.
  5. New York State residence is not required.

The Positions

Positions exist in Albany, Buffalo, Endicott, Melville, Menands, New York City, Rochester, Syracuse, and White Plains.

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As a Medical Care Representative with the State Insurance Fund, you would perform initial health care and vocational assessments, projecting long and short term goals; make recommendations for continuing care and/or suggest alternative treatment plans; and coordinate and monitor all health care and vocational services. You would assist claims personnel in interpreting medical reports and in implementing the medical cost control program. You would interview claimants and consult with attending physicians in order to facilitate claimant's medical care and rehabilitation. You would assess and evaluate the claimant within the family setting and identify the community resources available to the claimant. You would make recommendations to claims personnel concerning treatment, rehabilitation and equipment and review catastrophic cases to ensure the claimant is receiving proper and necessary care. You would review claims files and prepare reports concerning the status of your assignments. Duties would also include the evaluation of ICD/DRG/PAS/CPT coding for appropriateness and accuracy. You would be required to travel during the course of your duties.

As a Medical Care Representative with the Department of Law (Office of the Attorney General), you would perform similar types of activities as the State Insurance Fund, review medical actions to ascertain possible liability in malpractice suits filed against New York State, and aid attorneys in the preparation and defense of such cases.

As a Medical Care Representative with the Workers' Compensation Board, you would perform similar types of activities as the State Insurance Fund, monitor the medical management of high cost cases, monitor home care for injured workers, oversee physical therapy and nursing agencies, and train staff.

As a Medical Care Representative with the Office of Victim Services, you would perform similar types of activities as the State Insurance Fund, review the claimant's treatment plan to ensure services are allowable and causally related; review requests for home modifications necessary as a result of a disability due to a crime; review requests from claimants for high cost medical equipment (i.e., wheelchairs, beds, prosthesis, vehicle modifications, etc.); work with vendors for reasonable and customary costs; assist Additional Medical Unit personnel in interpreting medical bills and records; review medical bills, reports, and claimant requests for appropriateness to injuries sustained from the crime; prepare reports for Board Member review; review requests for educational assistance for job retraining; serve as the Public Access Defibrillation (PAD) Coordinator for the agency AED program; perform records management; develop and implement unit policies; and develop and maintain cooperative relationships with community resources to assist the victim in achieving pre-injury status or maximum potential.

As a Medical Care Representative with the Office of the State Comptroller, you would perform similar types of activities as the State Insurance Fund and provide technical expertise to audit staff assigned to healthcare related audits. The incumbent is required to travel to audit locations and interact with healthcare providers in fulfilling the duties of the position; the position evaluates medical coding for appropriateness and accuracy based on the review of patient medical records.

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Subject of Examination

There will be no written test. If you meet the Minimum Qualifications your education and experience will be evaluated against the general background/critical activities of the position. This evaluation will concentrate on the relevant registered nursing experience; level of registered nursing experience, undergraduate and graduate education; and current professional nursing certification. It is essential that you describe your education and experience as completely as possible on the NYS-APP Open Competitive Examination Application form. Ambiguity, vagueness, or omissions will not be decided in your favor. Do NOT send resumes. If you need more space, attach additional 8 1/2" x 11" sheets, following the same format used on the application form. Additional unsolicited information will not be accepted after the last day for filing.

All statements concerning education and experience are subject to verification. If references fail to respond or give contradictory information, you may be called upon to furnish written verification of the education and experience claimed. False statements or lack of proper verification may result in revocation of an appointment.

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.

Important: The Department of Civil Service and other state agencies may communicate with you through email correspondence. This may include the notification of your examination results and canvassing you for interest in appointment. It will be important for you to keep your email address, phone number and mailing address current by logging into

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How to Apply

Where to Apply:

Mail your completed application to:

  1. State Insurance Fund, Personnel Office, 15 Computer Drive West, Albany, NY 12205.

The New York State Insurance Fund, New York State Department of Law (Office of the Attorney General), Office of Victim Services, Office of the State Comptroller, and New York State Workers' Compensation Board have an ongoing need for persons qualified to fill these positions. The State Insurance Fund will accept applications for openings with their agency, the Department of Law (Office of the Attorney General), Office of Victim Services, Office of the State Comptroller, and Workers' Compensation Board at any time and will rate qualified applicants whenever additional eligibles are needed. Applications received after a rating period is completed will be retained for the next rating. Your name and score will be placed on the eligible list for one year.

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 unlawful 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, arrest and/or criminal conviction record, or any other category protected by law, 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 appointment.

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.

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 Accommodation Unit of the Department of Civil Service at

New York State Residence Is Not Required For Most Positions

However, you must be eligible for employment in the United States.

Continuous Recruitment/Eligible Lists

Candidates who meet the qualifications and pass this examination will have their names placed on the eligible list in the order of final scores, regardless of the date on which they filed or took the test. Generally, the names of qualified candidates will remain on the eligible list for one year. Appeal of ratings will not be allowed as the opportunity for retest exists. The Department of Civil Service reserves the right to terminate this special recruitment program.


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.