IF YOU ARE HIRED PROVISIONALLY IN THIS TITLE, YOU MUST TAKE AND PASS THE CIVIL SERVICE EXAM WHEN IT BECOMES AVAILABLE TO BE ELIGIBLE FOR CONTINUED EMPLOYMENT.

The Medical Assistance Program (MAP) administers public health insurance programs, including Medicaid, for the City of New York. Applying individuals and families are approved for eligibility against applicable Federal and State guidelines. Those found to be eligible can use coverage provided to access doctors, medication and other health care services at little or no cost.

The Medical Assistance Program (MAP) is recruiting for one (1) Eligibility Specialist II to function as Medicaid Eligibility Specialist, in MAP’s CREP unit, who will:


- Conduct a comprehensive review of applications including financial and legal documentation, as well as paid or unpaid medical bills submitted by applicants/recipients and authorized representatives.

- Perform budget calculations, obtain clearance reports, resolve resource matches and initiate other case actions utilizing the Eligibility Data and Image Transfer System (EDITS), Welfare Management System (WMS), MAP Pay-In System, eMedNY and the HRA One viewer.

- Determine eligibility for the appropriate level of Medicaid coverage for MAGI and Non-MAGI applicants and recipients.

- Prepare eligibility forms and notices to inform applicants and recipients of case disposition.

- Interview and/or review documentation submitted by applicants and recipients or authorized representatives, to determine eligibility for Medicaid.

- Respond to inbound and outbound telephone calls received from clients and/or authorized representatives with inquiries related to Medicaid coverage including possible questions related to the Excess Income Program or the applicant or recipients’ responsibility towards the cost of their care (NAMI-Net Available Monthly Income) if institutionalized.

- Assists consumers who need further assistance in understanding the eligibility criteria to qualify for the Excess Income Program.

- Perform other related assigned duties.

Salary Range: $42,485 - $48,858

Monday- Friday: 9AM – 5PM (1 HR)

1. Completion of 30 semester credits at an accredited college or university; or
2. A four high school diploma or its educational equivalent and one year of full-time satisfactory experience in one or more of the following areas; performing the work described below:
a. Interviewing, gathering information and/or preparing necessary documentation for the purpose of making recommendations concerning eligibility for public assistance or unemployment, health benefits, social security, insurance, or participation in social services or community programs, and other similar benefits; or
b. Performing bookkeeping, bank teller duties, housing office teller duties, purchasing agent, assistant store manager, sales representative responsible for accounts, or customer service duties or a job in which the duties include helping customers with questions or concerns; or
c. Dealing with social service agencies, legal representatives, or aiding individuals in navigating housing, social, financial or health problems or application systems; or
3. A satisfactory combination of education and/or experience equivalent to "1" or "2" above. College education may be substituted for the experience in "2" above on the basis that 30 semester credits from an accredited college or university may be substituted for each year of required experience. However, all candidates must have at least a four year high school diploma or its educational equivalent.
Special Note
Work experience which provides only incidental opportunities to perform the job duties as described in "2a", "2b" and "2c" above are not acceptable for meeting the minimum qualification requirements.

This position is also open to qualified persons with a disability who are eligible for the 55-a Program. Please indicate at the top of your resume and cover letter that you would like to be considered for the position through the 55-a Program.

As a prospective employee of the City of New York, you may be eligible for federal loan forgiveness programs and state repayment assistance programs. For more information, please visit the U.S. Department of Education’s website at https://studentaid.gov/pslf/.

New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview.

The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected characteristic, including but not limited to an individual's sex, race, color, ethnicity, national origin, age, religion, disability, sexual orientation, veteran status, gender identity, or pregnancy.