Professional, Senior Appeals Specialist
$51.4k/y-$68.4k/y
MVP Health Care2 days ago
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RemoteFull-timeMid
Summary
MVP Health Care is seeking a Professional, Senior Appeals Specialist to join their team in Remote. The role involves reviewing and processing quality of care concerns and complaints, as well as appeals filed by regulatory agencies.
About the Role
As a Senior Appeals Specialist, you will play a crucial role in the healthcare landscape, focusing on regulatory complaints and appeals. Your responsibilities include ensuring compliance with state and federal regulations, collaborating with the Legal team for Fair Hearings, and maintaining accurate records of appeals. You will contribute to enhancing healthcare delivery and building trust with regulators and stakeholders.
About You
Required:
- Bachelor's degree in law, healthcare administration, business or related field required.
- Associate's Degree with minimum 5 years' healthcare experience in lieu of Bachelor's Degree.
- Strong attention to detail and ability to manage multiple tasks simultaneously.
- Excellent communication skills, both written and verbal.
- Exceptional customer service skills and ability to handle difficult situations with empathy and professionalism.
- Proficient in using computer systems and software, including Microsoft Office Suite.
- Ability to work independently and as part of a team in a fast-paced environment.
- Strong organizational and time management skills.
Preferred:
- Curiosity to foster innovation and pave the way for growth.
- Humility to play as a team.
- Commitment to being the difference for customers in every interaction.
Benefits
- Growth opportunities to uplevel your career.
- A people-centric culture embracing and celebrating diverse perspectives.
- Competitive compensation and comprehensive benefits focused on well-being.
- An opportunity to shape the future of health care.
MVP Health Care
MVP Health Care is a nationally-recognized, regional not-for-profit health plan committed to having a positive impact on health and wellness of everyone we serve. With MVP, you are assured of quality health care and peace of mind—from a name you know and trust. We care for more than 700,000 members across New York and Vermont, creating healthier communities and continuing our 30-year legacy of quality and integrity. For more information, visit mvphealthcare.com.
Schenectady, NY