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- Sign-on bonus and referral bonus opportunities
- Generous paid time off and company holidays
- Comprehensive health insurance plan
- Employer-matched retirement funds
- Wellness programs
- Flexible spending accounts
- Tuition reimbursement
- Opportunities for career growth
- Internal mobility and advancement opportunities
- Stay updated on regulatory requirements for grievances and appeals
- Analyze and resolve complex issues related to medical care and services
- Coordinate grievance and appeal resolutions effectively and timely
- Review and authorize health services
- Collaborate with different departments for resolution
- Provide input for process improvement
- Enter data and compile reports
- Registered professional nurse in New York State
- Bachelor's Degree in Nursing required
- Master's Degree in Nursing preferred
- Minimum three years of healthcare experience
- Proficiency in Microsoft Office required
- Ability to work in a fast-paced environment
Grievance and Appeals Specialist, Clinical-2 - New York, United States - VNS Health
Description
OverviewHandles grievances, appeals, and external reviews for VNS Health Plans' product lines, ensuring compliance with regulations and accuracy standards. Manages day-to-day operations, maintains detailed records, and communicates outcomes effectively.
Compensation:$93, $116,800.00 Annual
What We Provide
What You Will Do
Licenses and Certifications:
Education:
Work Experience:
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