A&G Coordinator

Metropolitan Jewish Health System, Inc.; New York (NY); Híbrido; USD 55.000 - 75.000; Jornada completa

Descripción de la vacante

Metropolitan Jewish Health System, Inc. seeks an A&G Coordinator to investigate and respond to member and provider appeals and grievances in line with Contract Benefits, CMS and DOH rules. You will determine service types, investigate, and document cases, ensuring timely completion and proper review.

The role requires strong written and verbal communication, attention to detail, and the ability to manage multiple tasks and meet deadlines in a fast-paced health plan environment.

Formación

• Associates degree or equivalent preferred.
• 2 years prior related experience.
• Proficient in MS Word and Excel.
• Excellent written and verbal communication skills, attention to detail, ability to set priorities and meet deadlines, and manage multiple tasks.

Responsabilidades

• Investigate and respond to written or verbal appeals and grievances submitted by members and providers.
• Determine the appropriate type of service, appeal or grievance.
• Investigate and respond within time guidelines.
• Present cases for review and document all relevant information.

Conocimientos

Written communication

Verbal communication

Prioritization

Multitasking

Attention to detail

Educación

Associates degree or equivalent preferred

Herramientas

MS Word

Excel

Descripción del empleo

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Even in a non-clinical role, Elderplan employees have an opportunity to make a positive impact on the quality of our health plan members' lives.

The A&G Coordinator will investigate and respond to written or verbal appeals and grievances submitted by members and providers in accordance with Contract Benefits and CMS and DOH regulations. Key responsibilities include determining the appropriate type of service, appeal or grievance, investigating and responding appropriately and within time guidelines, presenting cases for review and documenting all relevant information.

• Associates degree or equivalent preferred.
• 2 years prior related experience.
• Must be proficient in MS Word and Excel.
• Excellent written and verbal communication skills, attention to detail, ability to set priorities appropriately and meet strict deadlines and the ability to manage multiple tasks simultaneously is required.