Operations Opportunities at EmblemHealth
Summary of PositionResponsible for overseeing the day-to-day operations of the Grievance and Appeal Specialists, ensuring adherence to department...
Summary of PositionRespond to written/verbal grievances, complaints, appeals and disputes submitted by members and providers in accordance with NCQA,...
Summary of Position Drive organizational efficiency and effectiveness by optimizing business processes. Lead teams, develop strategies, and...
Summary of JobContinuously and proactively assess and monitor enrollment and billing operations vendor performance to achieve contractual targets...
Summary of Position Process disputes submitted by contracted and non-contracted providers. Types of correspondence handled by the individual will...
Summary of Position Responsible for processing expedited appeals: those that are complex in nature, require multiple hand-offs, and tend to have...
REMOTESummary: Utilize pre/post claim editing, auditing, and claim recovery programs that will drive incremental value year over year: analyze and...