Coordinator 2-Appeals

Company:  Integrated Resources
Location: New York
Closing Date: 26/10/2024
Hours: Full Time
Type: Permanent
Job Requirements / Description
  • (8:00 am-5:00 pm or 7:30 am-4:30 pm -Monday-Friday)

Duration- 9-12 months
Essential Duties and Responsibilities:
  • Function as a Subject Matter Expert in one or more process areas.
  • - Analyze data submitted for Independent Medical Review.
  • - Conduct fact finding and analyses on those cases deemed complex in nature or requiring adjudication; apply established procedures where the nature of the system, feasibility, computer equipment and reporting tools have not already been decided.
  • - Track and meet required deadlines for complex cases or other assigned tasks.
  • - Assist leadership through research of data and/or authoring reports.
  • - Analyze data using all applicable state law, state regulations, process documents, and other sources as defined by the client contract.
  • - Work independently on specific situations or on a team to resolve problems and deviations according to current established practices; and obtains advice where precedents are unclear or not available from the client.
  • - Answer and respond to phone calls/emails from participants in the Independent Medical Review process.
  • - Assist others or provide on-the-job training or act as a mentor to production staff.
  • **********Minimum Requirements:
  • - High School Degree or equivalent required.
  • - 2-4 years of related professional experience required.
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