Human Resources

Medical Support Services Supervisor

DISTINGUISHING FEATURES OF THE CLASS: This is highly important work involving the cost benefit analysis of medical services, and the responsibility for planning and overseeing complex medical record keeping activities which may include independently performing the most important phases of such work.  The work may be performed on an alpha/numeric keyboard.  Work is performed under general supervision and in accordance with outlines policies and procedures but calls for the frequent exercise of independent judgment.  An employee in this position is responsible for insuring that medically related functions of the Department are carried out effectively.  Supervision may be exercised over lower level employees.  Does related work, as required.

TYPICAL WORK ACTITIES:
Plan, assign, and review the maintaining and checking of a wide variety of medical records and reports and instructs employees in the specialized details of this work;
Oversee and assist in the classification of a complex variety of receipts and expenditures and the distribution of costs according to prescribed codes;
Write policy and establish procedures for the medical transportation program;
Update Medicaid Medical Transportation Plan as needed, and submit changes to appropriate authority;
Correspond with medical transportation providers and resolves procedure and policy issues;
Responsible for overseeing personal care coordination between agencies, reconciling of MA Pay-In, preparing collection notices, etc.
Train new examiners in the detection and reporting of Third Party Health Insurance;
Determine cost effective payment of health insurance premiums from examiner referral and advise the examiner and recipient;
Complete a review of paid premiums to determine if continuation of premium payment remains cost effective;
Confirm health insurance coverage with insurance company and enter the Third Party insurance data into the state computer system;
Complete numerous reports and questionnaires generated by the New York State Department of Health;
Oversee the Child Teen Health Plan;
Oversee the Recipient Restriction Program, review restriction recommendations referred by the State Health Department;
Train new employees and attend training and meetings as necessary;
Review and insure proper designation of Medicaid State Charge and Overburden Aid for eligible clients.

The above examples of duties are intended only as illustrations of the various types of work performed.  The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment of the position.

FULL PERFORMANCE KNOWLEDGE, SKILLS, ABILITIES AND/OR PERSONAL CHARACTERISTICS; Thorough knowledge of modern methods used in maintaining medical records; thorough knowledge of office terminology, procedures, and equipment; good knowledge of Federal, State and local medical resources; good knowledge of the rules and regulations relating to medical services provided by the Social Services agency; ability to plan, assign and supervise the work of others; ability to understand and carry out complex oral and written directions; ability to make arithmetic computations rapidly and accurately; ability to prepare correspondence and reports; ability to secure the cooperation of others; ability to deal effectively with the public; good judgment in solving complex problems of the confidential nature of medical information concerning clients; full awareness of a high degree of accuracy, initiative and resourcefulness; tact and courtesy; integrity.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to sit, use hand to finger, handle, or feel objects tools, or controls; and reach with hands and arms.  The employee is occasionally required to walk, talk or hear.  The employee must occasionally lift and/or move up to 25 pounds.  Specific vision abilities required by this job include close vision and the ability to adjust focus.  The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  The noise level in the work environment is usually quiet.

MINIMUM QUALIFICATION:  Graduation from high school or possession of an appropriate equivalency diploma recognized by the NYS Department of Education, AND EITHER:
Possession of a Bachelor’s Degree; OR
Possession of an Associate’s Degree and two (2) years of full-time paid experience in examining, investigating and evaluating claims for assistance, one (1) year of which shall have dealt with the processing of medical insurance claims;    OR
Four (4) years of full-time paid experience in examining, investigating and evaluating claims for assistance, two (2) years of which shall have dealt with the processing of medical insurance claims.