Appeals and Grievances Coordinator

Elderplan, Inc. provides expanded Medicare health care coverage to seniors in all five boros for more than 20 years.  Advance your career with us and enjoy outstanding stability, growth potential and a world of options. 

 

We are currently looking for a temporary Appeals and Grievances Coordinator. The position will last between 3 to 4 months. In this position you will process provider appeals in order to ensure appeals are processed within the established regulatory time frames and provide support to the Grievances & Appeals Representative as needed. You will determine type of appeal; i.e.:  emergency room, inpatient (hospital or SNF), ancillary services (e.g. ambulance, laboratory, etc.). Send information to and requests information from other Elderplan Departments and providers. Track departments’ compliance with requested action. Forward and track correspondence and documents sent to and received from Center for Health Dispute Resolution (CHDR).Tracks informational requests from CHDR and ensures their timely response.

 

Qualifications: HS diploma or equivalent required. Must have Appeals and Grievances, Managed Care or Health Care related experience. Must be proficient in MS word, excel.

For consideration please apply on   We are an equal opportunity employer M/F/D/V