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 Position Support contract performance management of a large health system. ; Review and analyze suspected underpaid and overpaid claims...
Summary of Position To oversee the performance of vendors who are delegated for the claims processing function to ensure delegates meet and are...
Summary of PositionResponsible for receiving, researching and resolving provider inquiries received from UMR or internal departments and business...
Summary of Position Provide Claims project management oversight to ensure that outcomes are within defined parameters of cost, efficacy, and...
Summary of PositionProcess disputes submitted by contracted and non-contracted providers. Types of correspondence handled by the individual will...
Summary of JobRespond to written/verbal grievances, complaints, appeals and disputes submitted by members and providers in accordance with NCQA, CMS,...
Summary of Position Drive organizational efficiency and effectiveness by optimizing business processes. Lead teams, develop strategies, and...