Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

Provider Network Claims Support Leader

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Director and Equivalent
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191EQ Requisition #
Thanks for your interest in the Provider Network Claims Support Leader position. Unfortunately this position has been closed but you can search our 191 open jobs by clicking here.
Qualifications:
  • Bachelor’s degree, preferably in Business Management, Healthcare or related
  • 5-10 years' of managerial/supervisory experience with claims examining operations (e.g. Claims Processing and Adjudication processes) required
  • 5-10 years' experience maintaining large claims inventory, which includes tracking metrics of time service standards, payments of claims and notification of claims received, etc. required
  • 5-10 years' of Healthcare industry experience- hospital, commercial insurance company, or managed care organizations required
  • Strong knowledge of claims processing, procedures and systems, State, Federal and Medicare Regulations and Coordination of Benefits applications required
  • Working knowledge of MS Office- experience manipulating spreadsheets to create standardized reports, utilize vLookups, pivot tables, filter and use formulas required

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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