Office Assistant 2 (Calculations) (NY HELPS) (NYS Veterans' Home - Central Billing Office) - 41077, 64327

The NYS Veterans Homes Centralized Billing Office (NYS VH CBO) located in the village of Oxford is responsible for managing and administering the revenue cycle of the four NYS Veterans Homes located in Batavia (Genesee County), Montrose (Westchester County), Oxford (Chenango County) and St. Albans (Queens County). The staff of the CBO are the backbone of the revenue cycle, ensuring that patient services are accurately documented, coded, and billed to the correct payers, while also supporting collections and financial reporting.

The CBO is seeking to recruit administrative and operational support to perform the following responsibilities which directly impact the Homes’ financial stability, regulatory compliance, and the ability provide quality care:

• Data Entry & Documentation: Capturing and entering resident insurance details, admission records, and physician-ordered services into the billing system. This includes ensuring proper usage of CPT codes for billing services and ensuring all required documentation is in place prior to billing cycles.
• Eligibility & Authorization Verification: Verification of residents’ insurance coverage, prior authorizations tracking, and ensuring documentation meets payer requirements to prevent denial
• Claim Preparation & Submission: Preparing/submitting of clean claims for Medicare, Medicaid, private insurers, and other payers, ensuring compliance with long term care-specific rules (e.g., Medicare Part A coding, Part B therapy codes, Medicaid state requirements) Clerical staff often perform “Triple Check” reviews before submission.
• Payment Posting & Reconciliation: Recording payments (remittances, EOBs) into the billing software, matching them to resident accounts, and reconciling with bank deposits to ensure accurate financial records.
• Aging & Collections Support: Tracking outstanding balances, preparing statements for residents and families, and coordinating with collections staff to follow up on overdue payments.
• Denial Management Assistance: Identifying denial reasoning, preparing additional documentation requests (ADRs), and supporting appeals to recover payments, correction of denied claims and rebilling.
• Reporting & Compliance: Maintaining accurate billing records, applying rate changes, and ensuring compliance with healthcare regulations and payer guidelines.

Minimum Qualifications

Reassignment: Current NYS DOH Veteran's Home at Batavia employee with permanent or contingent permanent status as an Office Assistant 2 Calculations.

Transfers: Current NYS employee with one or more years of permanent, contingent-permanent, or 55 b/c service in a position eligible for transfer under Section 70.1 of Civil Service Law to Office Assistant 2 (Calculations). Eligible titles are available at: https://www.cs.ny.gov/businesssuite/title-transfer-matrix.cfm.

Promotion Provisional Appointment: In the absence of an eligible list with three or more candidates willing to accept a position, a temporary provisional appointment may be considered. For provisional appointment, candidates must meet the following minim qualifications be a current NYS DOH employee with one year as an office assistant, clerical, or keyboarding title allocated to Grade 6 or higher. Qualifying titles are available at: https://www.cs.ny.gov/examannouncements/announcements/38687titles.cfm.

If less than three interested and qualified NYS DOH employees serving in the direct-line, lower-level title(s) within the agency apply to this opportunity, the agency may make a non-competitive appointment under the NY HELPS program.

Open Competitive HELPS qualifications: One year of experience where most work time is spent performing mathematical operations, and/or clerical activities related to mathematical operations.

Preferred Qualifications: The Preferred candidate will have experience working a centralized billing office.