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Healthcare Organizational Operations Administrator- Item 1473

Department: Division of Operations and Systems (DOS)
Location: Menands, NY

Job Description

Division of Operations and Systems (DOS) in Albany, NY

General Responsibilities

  • The Division of Operations and Systems, Bureau of Medical Review is recruiting for 6 Healthcare Organizational Operations Administrators 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 a new initiative focusing on process improvement resulting in cost savings and staff efficiencies. 


    Minimum 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 (preferred)
    • The understanding of an EOMB (explanation of medical benefits preferred)


    Additional Requirements and Day-to-Day Tasks of Position

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


    • High School Graduate or Equivalent
    Three (3) years of administrative experience

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. VEVRAA Federal Contractor.  

Staffing Solutions Organization LLC is an e-Verify participant.

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