Medicaid Program Advisor

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.

Medicaid Program Advisor - Albany, NY

OQPS - 1155

Summary

This position will support data compliance program activities in the Center of Healthcare Data Innovation that support the NYS Medicaid program. 

The primary responsibility of the position will include setting deadlines, tracking submissions against targets, reviewing existing processes/documentation for improvement, and generating reports.

The incumbent will be expected to coordinate and communicate effectively with submitters, subcontractors, and office leadership. 

The successful candidate will perform a variety of activities including:

• Act as help desk support for required data content to be submitted or released, timely submission requirements or data request requirements, and enforcement of compliance requirements,
• Execute monthly compliance or data release process, including reviewing compliance report metrics or release report metrics to identify non-compliant submitters or efficiencies in data release, sending compliance warning notices to submitters or approved requestors, and responding to questions,
• Execute monthly process for submitter or requestor compliance exceptions and extensions,
• Review data content with other subject matter experts and system vendor for annual system update. 
• Support development of documentation for compliance and data request activities in appropriate trackers.

Desired Characteristics:

• Ability to work independently with excellent organizational, written, and oral communication skills.
• Effective time management skills to meet program timelines.
• Experience with supporting the development of sustainable processes and programs
• Proficiency in Microsoft Office products, including Word, Excel, and PowerPoint.
• Knowledge of health insurance claims data

Preferred Qualifications

• Experience in health insurance payment processes
• Experience with hospital revenue cycle including medical coding (CPT-4, ICD-10-CM) standards and medical claims (837I Health Care Claim Transaction – Institutional, 837P Health Care Claim Transaction – Professional).
• Medical coding certification through American Academy of Professional Coders (CPC, CPC-H) or American Health Information Management Association (CCS, CCS-P).
• Experience with healthcare compliance programs

Basic Qualifications:

• Bachelor's Degree in related field 
• 8 years experience