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© All Rights Reserved. ApplyBlast.com
Healthfirst
The Appeals Specialist serves as a subject matter expert for the Appeals & Grievances unit, handling non-clinical case development and resolution for member and non-contracted provider appeals across various health plans. This role involves investigating cases, interpreting regulations, and ensuring compliance with federal and state guidelines while managing a full caseload. The position requires independent decision-making, effective communication, and adherence to strict regulatory timeframes to resolve claims and appeals.
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.
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