Grievance and Appeals Specialist\n

VillageCareMAX\n

112 Charles Street, New York, NY 10014\n
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VillageCare is looking for a self-motivated individual for a Full Time role as the Grievance & Appeals Specialist. This position ensures that grievances and appeals are resolved accurately and appropriately while advocating for members. The specialist will act independently and communicate with providers, physicians, and Plan's departments to investigate and resolve grievances and appeals. Some daily activities will include:\n\nReceive, process, categorize and perform initial research on Grievance & Appeals.\nCorrespond with members and document as required by regulations.\nAccurately complete data entry and system documentation.\nCompliance with all regulatory and departmental timelines.\nParticipate on projects and individual special assignments as needed.\n\n

We would like to speak to those who have an Associate's Degree in a related field along with 2-3 years of work experience in an
Insurance Company, Workers Compensation, Disability, HMO or MLTC. Knowledge of appeals and grievances, claims processing or utilization management\/case management in a managed care organization required. Proficient with general computer software including Microsoft Excel, Word and Outlook. \n
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There are many benefits to working for VillageCare. If you are someone who likes being part of a team, enjoys a highly competitive benefits package from world leading carriers and competitive compensation, than we would love to speak with you! \n\nPTO package\n10 Paid Holidays\nPersonal and Sick time \nMedical\/Dental\/Vision\nHRA\/FSA\nEducation Reimbursement \nRetirement Savings 403(b)\nLife & Disability\nCommuter Benefits\nPaid Family Leave\nAdditional Employee Discounts\n\n
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VillageCare offers a wide range of at-home and community-based services, as well as managed long-term care options that seek to match each individual's needs to help them attain and maintain the greatest level of independent living possible. We are committed to superior outcomes in quality health care. \n
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VillageCare is an Equal Opportunity Employer.