Senior Consumer Frauds Representative Traineeship,Division of Social Justice, Health Care Bureau

Posted: 03/07/18 | SHARE:

Description:

The Health Care Bureau of the New York State Office of the Attorney General (OAG) is seeking a Senior Consumer Frauds Representative to join the Health Care Bureau’s Albany office to work as an advocate for the Health Care Bureau Helpline. This is a competitive class, provisional appointment. 

The principal mandate of the Health Care Bureau is to protect and advocate for the rights of health care consumers statewide.  In service of this mandate, the Bureau’s Helpline, which receives complaints via a toll-free number as well as an online complaint form and regular mail, provides assistance to thousands of New Yorkers annually.  Specifically, Senior Consumer Frauds Representatives, called Helpline “advocates,”  investigate individual complaints and mediate disputes to help protect consumers’ rights within the health care system.  Each year advocates secure millions of dollars in restitution and savings for New York consumers.  They provide invaluable assistance by helping consumers obtain (i) medically necessary care or prescriptions in the face of health plan denials, and (ii) reinstatement of health coverage that a health plan incorrectly terminated. In addition, advocates provide critical assistance to the work of the Bureau when their review of individual complaints helps to identify systemic problems in New York’s health care system; advocates assist in identifying cases suitable for broader enforcement actions and may assist attorneys with those investigations.

General responsibilities include, but are not limited to:

  • Reviewing health care plan documents and contracts;
  • advocating for resolution of the complaint through discussions and letters;
  • assisting with appeals;
  • monitoring health plans for violations of the law;
  • reviewing and/or mediating physician and hospital billing disputes; and
  • other duties, as assigned.

 

 

Qualifications:

  • Bachelor’s degree preferred but will consider applicants with at least sixty (60) semester credit hours completed at a regionally accredited college or university or paralegal certificate from a school or institute recognized by the American Bar Association;
  • at least one (1) year of experience where more than half your time was spent dealing with the general public in a sales or consumer/customer service or problem resolution capacity;
  • strong verbal and written skills preferred;
  • strong interpersonal skills preferred;
  • hard working, self-starter able to work independently, as well as in a team preferred;
  • ability to manage a large caseload preferred.

In addition, as a condition of continued employment, the selected candidate must take and pass the next scheduled Civil Service examination, and also be reachable on the resulting eligibility list. 

Additional Information:

Reference No. HCB_CFRT_ALB_6067

Applicants must be prepared to submit a complete application consisting of the following:

Please note: Failure to submit a complete application will delay the consideration of your application.

If you have questions regarding this position, including qualifications, please contact Andrew Clancy, Human Resources, (Andrew.Clancy@ag.ny.gov). 

For more information about the OAG, please visit our website: www.ag.ny.gov

Apply At: HCB_CFRT_ALB_6067; 

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