Grievance and Appeals Specialist - New York, United States - VillageCare
Description
Grievance and Appeals SpecialistVillageCareMAX112 Charles Street, New York, NY 10014VillageCare is looking for a self-motivated individual for a Full Time role as the Grievance & Appeals Specialist.
The specialist will act independently and communicate with providers, physicians, and Plan's departments to investigate and resolve grievances and appeals.
Some daily activities will include:
Receive, process, categorize and perform initial research on Grievance & Appeals.
Correspond with members and document as required by regulations.
Accurately complete data entry and system documentation.
Compliance with all regulatory and departmental timelines.
Participate on projects and individual special assignments as needed.
We would like to speak to those who have an Associate's Degree in a related field along with 2-3 years of work experience in anInsurance Company, Workers Compensation, Disability, HMO or MLTC.
Knowledge of appeals and grievances, claims processing or utilization management/case management in a managed care organization required. Proficient with general computer software including Microsoft Excel, Word and Outlook. There are many benefits to working for VillageCare.If you are someone who likes being part of a team, enjoys a highly competitive benefits package from world leading carriers and competitive compensation, than we would love to speak with you PTO package10 Paid HolidaysPersonal and Sick time Medical/Dental/VisionHRA/FSAEducation Reimbursement Retirement Savings 403(b)Life & DisabilityCommuter BenefitsPaid Family LeaveAdditional Employee DiscountsVillageCare offers a wide range of at-home and community-based services, as well as managed long-term care options that seek to match each individual's needs to help them attain and maintain the greatest level of independent living possible.
We are committed to superior outcomes in quality health care. VillageCare is an Equal Opportunity Employer.