SrAdmin-Appeals

Additional Information:
Hours of Operation: 9:00 am - 5:00 pm
Pay Rate: ***
Type: Remote
# of Positions: 1
Interview Process: TEAMS (video on from beginning to end

We are seeking a detail-oriented and service-driven Administrative Specialist to support the operations of the New York Independent Dispute Resolution Program. This role is essential in ensuring accurate data management, timely communication, and compliance with regulatory standards under the New York Surprise Billing Laws.

Key Responsibilities:
Data Collection & Analysis: Gather and review incoming documentation from treatment providers, healthcare facilities, program participants, laboratories, and health plans. Accurately input relevant data into internal systems to support case processing and program tracking.
Client Communication: Respond promptly and professionally to inquiries from clients, health plans, providers, and enrollees. Provide updates on case status and clarify program-related questions via email and other communication channels.
Required Skills & Qualifications:
Exceptional Attention to Detail: Precision is critical to ensure the integrity of shared information and maintain compliance with federal and state regulations. Accuracy helps prevent disputes and supports fair determinations.
Customer Service Orientation: Demonstrated ability to communicate effectively and empathetically with diverse stakeholders in a fast-paced environment.
Deadline-Driven Mindset: Comfortable working in a production-based setting with time-sensitive tasks and performance metrics.
Technical Knowledge:
o Familiarity with CPT (Current Procedural Terminology) codes
o Ability to interpret claim forms and Explanation of Benefits (EOBs)
o Understanding of the No Surprises Act and its impact on billing and dispute resolution processes
Preferred Experience:
Prior experience in healthcare administration, insurance claims processing, or regulatory compliance
Proficiency in data entry systems and case management platforms