Date Posted: 01/21/2026
Hiring Organization: Rose International
Position Number: 495921
Industry: Government
Job Title: Medical Claims & Prior Authorization Analyst
Job Location: Albany, NY, USA, 12260
Work Model: Onsite
Shift: M-F 9 am to 5 pm
Employment Type: Temporary
FT/PT: Full-Time
Estimated Duration (In months): 26
Min Hourly Rate($): 23.00
Max Hourly Rate($): 28.00
Must Have Skills/Attributes: Document Review, Medical Claims, Medical Terminology, Microsoft Excel, Microsoft Word
Experience Desired: Experience with Microsoft Word and Excel (1 yrs); Basic knowledge of medical terminology (1 yrs)
Required Minimum Education: High School Diploma or equivalent
Job Description
Required Education:
• High School Diploma
Required Qualifications/Skills/Experience:
• Experience with Microsoft Word and Excel
• Proficient in the use of standard office technology
• Basic knowledge of medical terminology
• Ability to be flexible, innovative, and work in a team environment
• Strong written and verbal communication skills
• Previous claims experience preferred but not required
Job Duties
• Providing clerical and administrative support to the Prior Approval Units, including the preparation, organization, and assembly of Fair Hearing packets that need to be mailed to members, representatives, and providers.
• Reviewing Fair Hearing packets for completeness and inclusion of all required documentation prior to distribution.
• Scanning and uploading all Fair Hearing documents for processing.
• Processing packages for mailing within required timeframes.
• Performing medical claims pricing for medical pending claims.
• Reviewing invoices, applying established pricing methodologies, and performing accurate calculations in accordance with Medicaid reimbursement rules.
• Entering pricing determinations and related data into the eMedNY system with a high degree of accuracy and attention to detail.
• Identifying discrepancies, missing documentation, or potential billing issues and escalating appropriately.
• Conducting initial and basic reviews of requests for durable medical equipment and medical supplies using established criteria.
• Escalating cases that fall outside of standard criteria to clinical staff (therapists, nurses, or other designated professionals) for further review and determination.
• Responding to basic inquiries from providers and members via phone and email regarding prior approval status, documentation requirements, and general policy guidance in a clear, professional, and courteous manner.
• Adhering to established workflows, turnaround times, and performance standards to support bureau-wide service level goals.
Benefits:
For information and details on employment benefits offered with this position, please visit here. Should you have any questions/concerns, please contact our HR Department via our secure website.
California Pay Equity:
For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here.
Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances.
If you need assistance in completing this application, or during any phase of the application, interview, hiring, or employment process, whether due to a disability or otherwise, please contact our HR Department.
Rose International has an official agreement (ID #132522), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13/10-91.).
I had a very positive experience working for Rose. The entire process is very efficient and easy.
Joanne, Consultant
It was great working for Rose International. Everyone was extremely helpful.
Rosann, Consultant
Rose International was not only attentive and responsive, but they were very professional and helpful whenever I called or needed any assistance.
Diane, Consultant
Any time I did have a question and called, the phone was always answered, and my question/concern was immediately resolved.
Sally, Consultant
Thanks for the opportunity. If in the future I ever need a job, I would like to work for Rose International.
David, Consultant
EMPLOYEE COMMENTS