NYS Insurance Account Specialist

Group Health Incorporated (GHI) is a statewide not-for-profit health insurer serving New Yorkers since 1937. GHI and its subsidiary GHI HMO provide health insurance and administrative services to more than 2.5 million individuals. GHI offers customers a variety of medical, hospital, dental, prescription drug, vision, and managed mental health coverage options, as well as administrative -services-only arrangements.  NYSID SPECIALIST

 

The responsibilities of this position include:

?  Investigates and resolves member, provider and other complaints presented by the New York State Insurance Department, and other governmental authorities and regulatory agencies, in a timely and judicious manner.

?  Obtain, analyze, and interpret GHI?s business records in order to investigate and resolve complaints.

?  Keeps abreast of GHI policies, procedures, contracts, and applicable laws and regulations, and monitors complaints for potential compliance issues.

?  Interacts verbally, in writing and/or in person with GHI management, governmental authorities, and complainants, as necessary.

?  Compose detailed, formal written replies and supply supporting documents to governmental authorities in response to complaints.

 

The qualifications for this position are:

?  College degree or equivalent work experience.

?  3-5 years progressively responsible GHI experience, including a minimum of two years in the GHI Service area; or 3-5 years of experience in a healthcare insurance environment.

?  Thorough knowledge of health insurance contracts, procedures and claims processing systems.

?  Ability to work independently and exercise professionalism and good judgment.

?  Excellent verbal, written and organizational skills.

 

We offer a competitive salary and comprehensive benefits package. For immediate consideration, please submit your cover letter, resume with salary requirements and job title:

 



 

At this time we are not using any third party Agency and/or Vendor for this position. Please do not contact or email us for additional information. Thank you.