A&G Coordinator
About The Position
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Even in a non-clinical role, Elderplan employees have an opportunity to make a positive impact on the quality of our health plan members' lives. At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.
Requirements
- Associates degree or equivalent preferred.
- 2 years prior related experience.
- Must be proficient in MS Word and Excel.
- Excellent written and verbal communication skills, attention to detail, ability to set priorities appropriately and meet strict deadlines and the ability to manage multiple tasks simultaneously is required.
Responsibilities
- Investigate and respond to written or verbal appeals and grievances submitted by members and providers in accordance with Contract Benefits and CMS and DOH regulations.
- Determine the appropriate type of service, appeal or grievance.
- Investigate and respond appropriately and within time guidelines.
- Present cases for review.
- Document all relevant information.
Benefits
- Tuition Reimbursement for all full and part-time staff
- Generous paid time off, including your birthday!
- Affordable and comprehensive medical, dental and vision coverage for employee and family members
- Two retirement plans! 403(b) AND Employer Paid Pension
- Flexible spending
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
