Company Statement
EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.
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Administrative Project Coordinator, Financial Recovery Unit
REMOTE
Summary of Position
- Responsible for managing the manual check workflow, ensuring appropriate documentation, quality review, and reconciliation of recovery payments.
- Coordinate key departmental meetings, maintaining agendas, task outlines and task follow-up.
- Manage escalated financial recovery issues, and ensure administrative processes operate efficiently and in compliance with regulatory and organizational standards.
- Responsible for supporting the operational integrity of financial recovery processes while ensuring administrative coordination, compliance, and effective departmental communication.
Principal Accountabilities
- Provide administrative oversight of the manual check process, ensuring submissions meet documentation and approval requirements prior to processing. Conduct quality reviews of manual check requests to confirm accuracy, completeness, and compliance with internal financial recovery procedures.
- Research and investigate recovery checks received without supporting documentation to determine appropriate claim attribution and disposition. Work independently to analyze data to identify trends and quality improvement opportunities. Track issues and monitor trends to support their resolution. Identify potential process gaps and document root cause analysis; present findings to management, and work with CTS for resolution.
- Support governance and operational initiatives such as Mass Recycle Governance and Negative Balance Improvement efforts by coordinating materials, reporting updates, and monitoring progress against action plans.
- Maintain organized records and documentation related to recovery activities, vendor payments, and operational initiatives.
- Collaborate with Claims, Finance, Compliance, and Operations teams to ensure alignment on recovery processes and administrative workflows. Serve as key contact to internal and external stakeholders to ensure deadlines are met; provide recommendations for problem resolution; direct/escalate inquiries and issues if needed; ensure proper implementation of needed actions; follow up with appropriate actions to ensure resolution.
- Perform active research to prepare and present new ideas to improve current processes which impact the business.
- Provide support on all administrative matters, recording meeting minutes and following up on important internal and external meetings; perform reporting and other tasks as needed.
- Coordinate and track escalated issues related to financial recoveries, working with internal teams and external partners to ensure timely resolution Process and approve vendor invoices related to recovery operations, ensuring proper documentation, coding, and alignment with contractual agreements
- Identify opportunities to improve administrative efficiency and support continuous process improvement within the department.
- Perform other duties as assigned or required.
Qualifications
Education, Training, Licenses, Certifications
- Bachelor’s degree, preferably in healthcare administration, finance, operations, business administration, or a related field required; Additional years of experience/specialized training may be considered in lieu of educational requirements
Relevant Work Experience, Knowledge, Skills, and Abilities
- 2 – 3+ years of relevant, professional work experience including positions handling confidential information required
Experience as a project analyst in a related field; strong understanding of project management required
- Familiarity with CMS regulations and healthcare payer operational standards required
- Proficiency with healthcare claims processing platforms such as FACETS and related operational systems required
- Attention to detail; ability to identify and resolve issues; ability to perform data analysis required
- Experience in the health care industry preferred
- Strong proficiency with MS Office (Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.) required
- Excellent communication skills (verbal, written, presentation, interpersonal) with all types/levels of audiences required
- Ability to maintain a calm, professional demeanor, confidentiality, and to effectively complete multiple tasks/projects with competing priority levels and deadlines required
Security Disclosure
If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.
Pay Disclosure
At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.
EEOC Statement
We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, age, creed, citizenship status, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.