New York Appeals Coordinator

Job Summary

A company is looking for an Appeals and Grievances Clinical Coordinator.

Key Responsibilities

• Prepare cases for clinical review by gathering documentation and organizing evidence
• Perform administrative tasks including generating determination and authorization notification letters
• Ensure timely processing of appeals and grievances in compliance with state and federal regulations

Required Qualifications

• High School Diploma or GED
• Bachelor's degree preferred
• Knowledge of NY state and federal regulations is highly desirable
• Proficiency in Microsoft Office required
• Understanding of claims payment processes and related systems