NJM Insurance Group

More Than 100 Years of Earning Trust

Complaint Resolution Analyst

AnalystAnalystFull TimeRemoteTeam 1,001-5,000Since 1913H1B No SponsorCompany SiteLinkedIn

Location

Connecticut + 3 moreAll locations: Connecticut, New Jersey, New York, Pennsylvania

Posted

32 days ago

Salary

$50.1K - $67.1K / year

High School2 yrs expEnglish

Job Description

• Researches, investigates and coordinates resolution to member and/or provider complaints • Utilizes IMAC database to extract complaint information and tracking log • Ensures complaint resolutions meet State timing requirements to ensure compliance • Gathers data to compile monthly and quarterly statistical reports • Conducts extensive follow-up with internal areas • Writes complaint resolution letters to physicians and members • Reviews the complaint database report weekly and follow-up on outstanding issues • Completes and/or assist with monthly reporting requirements • Performs any other duties as assigned by management.

Job Requirements

  • High School Diploma/GED required
  • Requires 2 years customer service or health care experience
  • Requires knowledge of health care delivery systems
  • Requires knowledge of PC's and related software
  • Prefers knowledge of State and Federal regulations
  • Requires strong verbal and written communications skills
  • Requires strong analytical and logical thinking
  • Requires use of good grammar, diction and articulation
  • Requires good computer skills
  • Requires conflict resolution skills
  • Requires customer focus with excellent listening skills
  • Requires focus on quality.

Benefits

  • Comprehensive health benefits (Medical/Dental/Vision)
  • Retirement Plans
  • Generous PTO
  • Incentive Plans
  • Wellness Programs
  • Paid Volunteer Time Off
  • Tuition Reimbursement

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