Tiffany Canning

• Work within the NY State of Health Marketplace determining eligibility/enrollment for all financial and non-financial health insurance programs offered through the NYS Marketplace using several software systems (NYSOH, eMedNY, NY-HX)
• Ensure eligibility and enrollment is correct and assist with updating accounts directly with consumers or working with contracted personnel
• Sample and report quality assurance for all staff under centralized process
• Produce several monthly and quarterly quality assurance reports for the Bureau
• Work with developers and system staff to report, monitor and provide feedback on system errors and corrections
• Supervise subordinate staff

Determine eligibility and enrollment for all financial and non-financial programs offered through NYSOH marketplace.

Work within databases to help assist consumers with reported eligibility and enrollment issues they are experiencing using current work instructions and job aides.

Contact consumers and representatives to determine course of action to get correct eligibility and enrollment

Submit data corrections to GDIT and work with developers to correct system issues or system limitations

Started at the beginning of NYSOH marketplace integration, assisting with system issues and error resolution with contracted developers to ensure correct system is functioning correctly; submit data corrections.

Ensure correct eligibility and enrollment is given to consumers using the NYSOH marketplace; using various programs (NYSOH, eMedNY, RCL, Excel, Microsoft)

Work directly with consumers and representatives to determine best course of action get get eligibility determined and enrollment processed.

Responded to allegations of suspected maltreatment and abuse of children.

Worked directly with public and other agencies to ensure children are safe and needs are met. Referred to available resources

Worked within the court, judicial and law enforcement system to mandate programs and resources for child and family safety.

Evaluated and provided home care programs for Medicaid eligible consumers who required personal and other care needs to remain in their homes.

Worked directly with consumers in their home and nursing staff to determine the amount of home care hours are necessary and within the Medicaid Home Care program Scope

Worked directly with consumers applying for Medical Assistance within Madison County

Performed face to face interviews going over the application and documents submitted; then determining eligibility for Medicaid other health insurance programs using pre-established eligibility guidelines.

Performing recertification and undercare maintenance of eligibility for a set caseload of individuals in the community.

Worked with outside agencies to determine eligibility and referrals to outside resources or other social service programs