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© All Rights Reserved. ApplyBlast.com
Healthfirst
The Appeals & Grievances Clinical Specialist investigates and responds to member and provider clinical appeals and grievances, ensuring proper classification and adherence to company policy. This role involves entering data into medical management systems, collaborating with other departments for thorough investigations, and preparing for regulatory site visits. Successful candidates will manage large caseloads independently while utilizing various computer applications to process claims and grievances efficiently.
Headquarters
New York, New York, United States
Company Size
1001-5000 employees
Founded
1993
Healthfirst is a New York-based health insurer offering Medicare Advantage, Medicaid, Essential Plans, Child Health Plus, and other individual and family plans, along with long-term care options. Serving New York City, Long Island, Westchester, Rockland, Sullivan and surrounding areas, Healthfirst emphasizes a broad provider network, care coordination, and member resources to help New Yorkers access affordable health coverage.
5% below the average for this role