Job Details

  • Title: Complaints & Appeals Associate
  • Code: RCI-ZON-7640-1
  • Location: Newark New Jersey (NJ) 07105
  • Posted Date: 10/02/2019
  • Duration: 3 Months
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  Job Description

Some travel may be required between 3 Penn Plaza, Newark, NJ and 1427 Wyckoff Road, Wall, NJ. Position may extend into 2020. Looking for someone who is willing to get involved and become part of the team.

Assists with HIPAA Personal Rep requests and maintenance of HIPAA records within prescribed timeframes as mandated by the regulatory entity and per designated quality standards

Responsibilities:

• Conduct Validation process on HIPAA requests to create personal rep statuses on the system for release of medical information.
• Once information has been validated, update database and all downstream systems with the Personal Rep information.
• Compose acceptance or denial letters (including reason for denial) and/or request for additional information.
• Contacts relevant party(ies) to ask addition questions if necessary.
• Conduct research for missing information and update where necessary.
• Other duties as assigned.

Skills and Abilities:

• Understand and use language correctly, to be determined by the Language skills test.
• keyboarding proficiency.
• Ability to perform basic arithmetical calculations.
• Read, understand and interpret written materials.
• Ability to analyze information and to understand and apply rules and procedures.
Ability to compose business letters.
• Strong research, investigative, analytical, decision making and problem solving skills.