Senior Appeals Specialist

6 days ago


New York, New York, United States Integrated Resources Full time

Company Overview:

We are Integrated Resources, a dynamic organization dedicated to providing exceptional services. Our team is passionate about delivering top-notch support, and we're looking for a skilled Senior Appeals Specialist to join our ranks.

About the Role:

This role involves assisting with daily administrative tasks, prioritizing workflow effectively, and providing excellent communication skills. You will work closely with members, representatives, health plans, and clients to ensure timely and professional interactions.

Key Responsibilities:

  • Assist with daily clerical tasks, focusing on prioritization and efficient execution
  • Handle verbal decisions, appeal acceptance, and requests for medical records from health plans and representatives via phone calls
  • Monitor and maintain high-volume workflows through shared mailboxes, fax, and email systems, ensuring prompt and professional communication
  • Analyze and input incoming and outgoing data to guarantee the security of sensitive information (PHI/PII)
  • Stay updated on project and corporate policies, procedures, and guidelines as outlined in the employee manual and other relevant documents
  • Manage emails and phone calls efficiently, promoting effective communication within and outside the organization

Requirements and Skills:

  • Proficiency in using Microsoft Teams, Excel, Word, and Adobe software
  • Desirable: experience with Salesforce, SharePoint, and Genesys telephony systems
  • A minimum of 2+ years of experience or an Associate's degree; or equivalent experience in lieu of an Associate's degree (HS Diploma or GED and 4+ years of experience)

Compensation:

The estimated salary range for this role is between $38,000 and $48,000 per annum, depending on location and performance. This figure is based on industry standards and market rates for similar positions.



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