Operations Opportunities at EmblemHealth
Summary of Position Responsible for processing expedited appeals: those that are complex in nature, require multiple hand-offs, and tend to have...
Summary of Position Responsible for receiving, researching and resolving inquiries and requests from internal EmblemHealth departments and business...
Summary of Position Support contract performance management of a large health system. ; Review and analyze suspected underpaid and overpaid claims...
Summary of Position Provide Claims project management oversight to ensure that outcomes are within defined parameters of cost, efficacy, and...
REMOTESummary of Position Responsible for leading complex COB investigations across all lines of business, including governmental and commercial...
REMOTESummary of Position Responsible for investigating common and complex coordination of benefits and other party liability issues, determining,...
REMOTESummary of Position Develop/gather business requirements for queries needed to analyze vendor payment data. ; Utilize pre/post claim editing,...
REMOTESummary of Position Responsible for leading and optimizing the organization’s secondary payer and revenue recovery processes across all lines...
Summary: Facilitate Operations training programs; evaluate and maintain those programs to ensure they are current and effective. ; Responsible for...
Summary of Position Responsible for assessing the quality of performance of employees who handle calls from our existing and potential members,...