ApplyBlast uses AI to match you with the right jobs, tailor your resume and cover letter, and apply automatically so you can land your dream job faster.
© All Rights Reserved. ApplyBlast.com
ApplyBlast uses AI to match you with the right jobs, tailor your resume and cover letter, and apply automatically so you can land your dream job faster.
© All Rights Reserved. ApplyBlast.com
Healthfirst
The A&G Clinical Specialist serves as the subject matter expert for clinical case development and resolution within Healthfirst's Appeals & Grievances unit. The role manages a caseload of member and provider complaints, appeals, and grievances, ensuring compliance with federal and state regulations while coordinating with internal and external stakeholders. Responsibilities include researching issues, interpreting policies and regulations, preparing cases for medical director review and external appeals, and maintaining thorough documentation within regulatory timeframes.
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.
8% below the average for this role