Senior A&G Coordinator

Metropolitan Jewish Health System; New York (NY); On-site; USD 61,463 - 73,755; Full time

Benefits offered by this job

Tuition Reimbursement

Generous paid time off

Comprehensive medical, dental & vision coverage

403(b) AND Employer Paid Pension

Flexible spending

Job summary

Metropolitan Jewish Health System seeks an A&G Analyst to support compliance with External Appeals and QIO case files. This role requires strong communication skills and proficiency in Microsoft Office.

Applicants should have a BA/BS degree and 3-4 years of relevant experience, preferably in Managed Care. Benefits include comprehensive health coverage and tuition reimbursement.

Qualifications

• 3-4 years of prior experience in Managed Care or Healthcare organizations.
• Ability to handle confidential aspects of the position.
• Ability to work closely with professionals in a healthcare team.

Responsibilities

• Prepare, communicate, and submit External Appeals and QIO case files.
• Complete all quarterly DOH, CMS, and departmental reports.
• Serve as a backup for the A&G Fair Hearing Coordinator.

Skills

Excellent written and oral communication skills

Good analytical abilities

Customer service skills

Ability to work independently

Proficiency in Microsoft Word, Excel, PowerPoint

Empathetic and understanding

Ability to set priorities

Education

BA/BS degree or equivalent, relevant experience

Tools

Telephone

Fax

Email

Scanner

Job description

Overview

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.

The MJHS Difference

At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.

Benefits include:

• Tuition Reimbursement for all full and part-time staff
• Generous paid time off, including your birthday!
• Affordable and comprehensive medical, dental and vision coverage for employee and family members
• Two retirement plans! 403(b) AND Employer Paid Pension
• Flexible spending
• And MORE!

MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)

Responsibilities

As a support to the A&G Department, the A&G Analyst is responsible for the preparation, communication, and submission of External Appeals and QIO case files to the Department and Financial Services (DFS) and the Quality Improvement Organization (QIO). Complete all quarterly DOH, CMS, and departmental reports. Serve as a backup for the A&G Fair Hearing Coordinator and the A&G Senior Specialists and other A&G staff as needed. Assist with VAM upgrades, and training as needed. The position requires excellent communication, time management, and proficiency in multiple systems to facilitate the timely gathering of documentation, communication, and collaboration between responsible parties to ensure compliance with all State and Federal Regulatory Requirements.

Qualifications

• BA/BS degree or equivalent, relevant experience required.
• 3-4 years prior related experience is requirpreferablybly in Managed Care or Health Care related organizations.
• Telephone, Fax, Email, Scanner, Microsoft Word, Excel, Powerpoint, capacity to learn other programs as assigned.
• Excellent written and oral communication skills.
• Good analytical abilities.
• Ability to be empathetic and understanding.
• Ability to handle confidential aspects of the position.
• Ability to work closely with different professionals as part of an interdisciplinary healthcare team.
• Good customer service skills.
• Ability to set priorities.
• Ability to work independently while recognizing issues having a departmental or organizational impact.
• Ability to maintain collegial relationships and work in an interdisciplinary team environment.

Min

USD $61,463.13/Yr.

Max

USD $73,755.75/Yr.