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.
Expedited Appeals Specialist
Education, Training, Licenses, Certifications
• Bachelors’ degree.
Relevant Work Experience, Knowledge, Skills, and Abilities
• 3 – 5+ years of related experience, preferably in the health industry and/or area of compliance. (R)
• Additional related experience/specialized training may be considered in lieu of degree requirements. (R)
• Extensive knowledge and experience in claims, enrollment, benefits, and member contracts. (R)
• Ability to mentor specialists and to provide assistance on complex cases. (R)
• Must be well versed in all aspects of the complaint, grievance and appeal process and be able to process all types of correspondence handled by Grievance and Appeals. (R)
• Proficiency in MS Office (Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.). (R)
• Excellent product knowledge. (R)
• Excellent prioritizing, organizing, time management, problem solving and analytical skills. (R)
• Ability to work under pressure and deliver complete, accurate, and timely results. (R)
• Leadership skills. (P)
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, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
EmblemHealth may provide work visa sponsorship depending on factors such as business unit requirements, position nature, costs, and applicable laws and regulations.