Medicare Reimbursement Specialist

Additionally, OLR administers the Health Benefits Program, Management Benefits Fund, Employee Assistance Program, Work Well NYC, Medicare Part B Reimbursement, and Pre-Tax Benefits & Citywide Programs, including the Deferred Compensation Plan and NYCE IRA.

In addition to negotiating collective bargaining agreements, OLR serves as a resource to agencies regarding labor issues and works with the Municipal Labor Committee (MLC) to pursue innovations in a variety of areas, particularly regarding City health insurance programs.

OLR staff assist their fellow agencies in handling personnel and payroll issues, conducting labor-management meetings, representing the City at representation hearings, and handling all employee grievances and arbitration matters, while also negotiating collective bargaining agreements with the City's 149 bargaining units.

Job Description

The City reimburses City retirees who pay Medicare Part B and/or Income-Related Monthly Adjustment (IRMAA) premiums. The Health Benefits Program receives, on average, 12,000 new Medicare Part B applications annually and 17,000 IRMAA applications every year.

These applications must be reviewed for eligibility and processed between May and September each year in order to meet the Medicare Part B and IRMAA reimbursement annual payments in April and October of every year.

The Medicare Reimbursement Specialist will be responsible for:

• Processing Medicare cards for Medicare-eligible retirees and their Medicare-eligible dependents to ensure reimbursement of standard Medicare Part B premiums.
• Reviewing required documentation to determine eligibility for IRMAA reimbursement.
• Processing complete IRMAA reimbursement applications accurately and within established deadlines.
• Troubleshooting Medicare Part B and IRMAA reimbursement issues and corresponding directly with retirees to resolve payment and eligibility concerns.
• Serving as the liaison with agencies and participating employers regarding reimbursement matters affecting retirees and their eligible dependents.
• Ensuring compliance with program policies and maintaining accurate records related to reimbursement activity.

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.