Insurance and Claims Specialist I

Applications to be submitted by June 12, 2026 Compensation Grade: P14 Compensation Details: Minimum: $56,025.00 - Maximum: $56,025.00 Annually Positions with a designated work location in New York City, Nassau, Rockland, Suffolk, or Westchester Counties will receive a $4,000 annual downstate adjustment (pro-rated for part-time positions). Department (OHEHR) AI - AIDS Institute Job Description: Responsibilities The New York State Department of Health, AIDS Institute has established eight Uninsured Care Programs, of which some of these programs have the most comprehensive drug and service coverage in the country. The programs provide access to medical services and medications for all New York State residents with or at risk of acquiring HIV/AIDS. The programs bridge the gap between Medicaid coverage and private insurance and serve as a transition to Medicaid by providing interim assistance to individuals eligible for but not yet enrolled in Medicaid or assistance in meeting spenddown requirements. The Insurance and Claims Specialist I will be responsible for APIC reimbursement processing; pharmacy, primary care, home care and APIC payment processing; handle complex fiscal hotline calls; assist providers and participants with the coordination of benefits; assist with staff training; other appropriate related duties. Minimum Qualifications Bachelor's degree in a related field; OR an Associate's degree in a related field and two years of general office, secretarial, or administrative experience; OR four years of such experience. Preferred Qualifications At least one year of experience in a health care program providing services to people living HIV/AIDS. At least two years of customer service experience in a financial or medical field. At least two years of medical claims or insurance experience. Knowledge of COBRA, HIPAA, and coordination of benefits. Conditions of Employment Grant funded position. Compliance with funding requirements such as time and effort reporting, grant deliverables, and contract deliverables, is required. Valid and unrestricted authorization to work in the U.S. is required. Visa sponsorship is not available for this position. The selected candidate must reside within a reasonable commuting distance of the official work location specified in the job posting and must also be located in or willing to relocate to one of the following states: New York, New Jersey, Connecticut, Vermont, or Massachusetts, prior to hire. This position is fully onsite and does not allow telecommuting. HRI participates in the E-Verify Program. Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans www.healthresearch.org About Health Research, Inc. Join us in our mission to make a difference in public health and advance scientific research! At Health Research, Inc. (HRI), your work will contribute to meaningful change and innovation in the communities we serve! At HRI, we are on a mission to transform the health and well-being of the people of New York State through innovative partnerships and cutting-edge public health initiatives. As a dynamic non-profit organization, HRI plays a crucial role in advancing the strategic goals of the New York State Department of Health (DOH), Roswell Park Comprehensive Cancer Center (RPCCC), and other health-related entities. HRI offers a robust, comprehensive benefits package to eligible employees, including: Health, dental and vision insurance - Several comprehensive health insurance plans to choose from; Flexible benefit accounts - Medical, dependent care, adoption assistance, parking and transit; Generous paid time off - Paid federal and state holidays, paid sick, vacation and personal leave; Tuition support - Assistance is available for individuals pursuing educational or training opportunities; Retirement Benefits - HRI is a participating employer in the New York State and Local Retirement System and offers optional enrollment in the New York State Deferred Compensation Plan. HRI provides a postretirement Health Benefits Plan for qualified retirees to use towards health insurance premiums and eligible medical expenses; Employee Assistance Program - Provides educational and wellness programs, training, and 24/7 confidential services to assist employees, both personally and professionally; And so much more! Work Location Expectations At HRI, the nature of hybrid and onsite work varies by position. Some roles require full onsite presence, while others allow a hybrid schedule. Managers determine the specific telecommuting expectations for each role based on operational needs and job responsibilities. If designated as hybrid, you will divide your time between working remotely and reporting onsite. Regardless of telecommuting status, all HRI employees must live within a reasonable commuting distance of their official work location and must reside in one of the following states: New York, New Jersey, Connecticut, Massachusetts, or Vermont. As the Executive Director of Health Research, Inc. (HRI), I would like to welcome you to HRI's career page. HRI's mission is to build a healthier future for New York State and beyond through the delivery of funding and program support to further public health and research programs in support of the New York State Department of Health, Roswell Park Comprehensive Cancer Center and other entities. This achievement is made possible through the recruitment of highly talented and qualified individuals. As an Equal Opportunity and Affirmative Action employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, age, disability, protected veteran status, or any other characteristic protected by law. HRI is committed to fostering an environment that encourages collaboration, innovation, and mutual respect and we strive to ensure every individual feels welcomed and appreciated. We invite you to explore and apply for any open positions that align with your interests. --- If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. You can request reasonable accommodations by contacting HRI Human Resources at ... or ....