Location: Albany,NY, USA
Job Description: Evaluate External Appeal applications for eligibility based on requirements in Insurance Law Article 49. Request necessary information from appropriate party and respond to questions about the process. Investigate complaints against regulated insurance companies, applying mandates in Insurance Law and provisions in the approved policy. Request necessary information from appropriate party and communicate findings when the investigation is complete. Client will train the paralegal on the internal process and applicable Laws. Duties: • Screen requests for Appeals in accordance with the Federal No Surprise Act. • Screen requests for External Appeal in accordance with Insurance Law, Regulation and the established protocols. • Act as liaison using written and verbal communication for administrative processes with consumers and representatives of financial entities. • Keep electronic case files updated, complete and organized. • Research, process and resolve consumer and provider complaints. Skills: • Excellent writing and communication abilities are preferred. • Should be a self-starter, outgoing and team-oriented. • Strong attention to detail and organizational skills are a must. • Ability to understand legal mandates • Ability to work effectively and professionally with higher level management staff is essential. • Computer proficiency in Microsoft Office Suite, including Outlook, Word, Excel, etc. is a mandatory component of the assignment. • Reliability, and time and attendance is critical. Additional Information: - A background check and fingerprinting will be required. The background check should include verification of education and employment - Interviews will be conducted via Microsoft Teams - Client does not provide parking, but there is metered parking around the building and the office is accessible by bus. - Once onboarded, Client currently has a 50% telecommuting policy in place. - Basis for award is best value