Coordinator1-Appeals
1 month ago
NY Pittsford (NSA)
Position: Coordinator Appeals
Pay: ***/hr
Dixon (8:00 am-5:00 pm or 7:30 am-4:30 pm -Monday-Friday)
Overview: We are seeking a detail-oriented and knowledgeable individual to join our team as a Federal No Surprise Act Coordinator-Appeals.
Key Responsibilities: 100%
•
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
• - Function as a Subject Matter Expert in one or more process areas.
• - Analyze data submitted for Independent Medical Review.
• - Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
• - Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
•
**********Minimum Requirements:
- Associate degree with 2+ years' experience.
Experience:
• Experience in healthcare law, arbitration, mediation, dispute resolution or claims adjudication in healthcare.
• Strong analytical and critical thinking skills.
• Excellent written and verbal communication abilities.
• Ability to handle sensitive information with integrity and confidentiality.
Skills:
• Persuasive communication skills (both written and verbal).
• Critical and analytical thinking.
• Familiarity with healthcare finance and insurance practices.
• Experience working with federal healthcare regulations.
• Attention to detail.
• Proficiency in operating across various platforms and displays.
• Ability to work efficiently and independently.
• Able to follow processes and procedures.
• 2 years' experience in healthcare, claims and/or appeals adjudication in healthcare required
• Knowledge of Medical and Insurance Terminology
• Strong analytical and critical thinking skills.
• Proficiency in Microsoft Office Suite and experience with database management•
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