Integrated Resources, Inc

Company Details

Complaints and Appeals Associate

Job ID

: 22755


: Newark, NJ, USA


: Not Specified

Job Views

: 63


: 10-14-2019

Job Description

Job Role: Complaints and Appeals Associate

Job Location: Newark, NJ

Job Duration: 3+ Months


Position Comments:     

  • Position may extend into 2020. Looking for someone who is willing to get involved and become part of the team.


Job Description:              

  • 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
  • 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:

  • Requires the ability to understand and use language correctly, to be determined by the Language skills test.
  • Requires keyboarding proficiency.
  • Requires the ability to perform basic arithmetical calculations.
  • Requires the ability to read, understand and interpret written materials.
  • Requires the ability to analyze information and to understand and apply rules and procedures.
  • Requires the ability to compose business letters.
  • Excellent interpersonal skills (i.e. active listening).
  • Strong research, investigative, analytical, decision making and problem solving skills.
  • Ability to perform in high pressure situations.
  • Ability to multitask.
  • Ability to manage and diffuse irate callers.
  • Time management skills.



  • The Employer may require an employee to pass an additional test(s) as a part of determining whether the applicant meets the minimum qualifications for the job.
  • (Written test to confirm candidate can write/compose a letter)


Travel (If Applicable):

  • Some travel may be required between 3 Penn Plaza, Newark, NJ and 1427 Wyckoff Road, Wall, NJ


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Job Category
Employment Types
Contract - W2
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