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Grievance and Appeals Specialist (Hybrid)

Manhattan, NY 10017

Posted: 07/27/2026 Employment Type: Contract Job Number: 28862703 Pay Rate: 33-35 USD/Hour

Job Description


Now Hiring: Grievance & Appeals Specialists
New York, NY | Hybrid/Onsite | Full-Time
$30-$35/hour

Are you an experienced Grievance & Appeals professional with a background in Medicare or Medicaid Managed Care? We're partnering with a leading healthcare organization that's looking to add multiple specialists to their growing team.

If you're someone who thrives in a fast-paced environment, understands CMS regulations, and enjoys ensuring members receive timely, accurate resolutions, we'd love to connect with you.
What You'll Do

  • Review, investigate, and resolve member and provider grievances and appeals

  • Ensure all cases are processed within CMS, Medicare, Medicaid, and New York State regulatory timelines

  • Partner with Medical Directors, Claims, Provider Relations, Pharmacy, and other departments to resolve cases efficiently

  • Prepare clear, professional written correspondence for members, providers, and regulatory agencies

  • Track appeal deadlines and maintain accurate case documentation

  • Assist with Fair Hearings, External Appeals, and Independent Review Entity (IRE) cases

  • Escalate complex cases when appropriate

  • Support audits and contribute to process improvement initiatives
What We're Looking For

  • At least 2 years of Grievance & Appeals experience in a Medicare and/or Medicaid Managed Care environment

  • Strong knowledge of CMS, Medicare, Medicaid, and New York State regulations

  • Excellent communication and organizational skills

  • Detail-oriented with strong analytical abilities

  • Proficiency with Microsoft Office

  • Experience with FACETS is a plus

  • Bachelor's degree preferred (or equivalent experience)
Compensation
$30-$35/hour, based on experience.

If you're ready for your next opportunity—or know someone who is—we'd love to hear from you. Apply today or message me directly for more information. Referrals are always welcome!

Meet Your Recruiter

Stacey Behar

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About Manhattan, NY

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Drew Anson

Chief Delivery Officer

Drew Anson is Chief Delivery Officer at Phaxis, a Workforce Solutions Company based in New York.

In this role, Drew leads the delivery and recruiting working closely with the leadership team to define a model that is efficient at supporting the firm s current needs and is scalable for future growth.

Drew is a seasoned executive with more than 13 years of Services & Recruitment experience. In that time, he has supported numerous Fortune 100/500/1000 organizations across industries by providing global workforce solutions, namely resources and thought leadership for large-scale projects, implementations, and managed services.

Prior to joining Phaxis predecessor firm Park Hudson in 2021, Drew spent three years at engineering technology and talent solutions firm, Collabera, as Director of Sales in North Carolina. Earlier in his career, he spent nearly eight years at Insight Global, most recently as Sales Manager of the Columbus, OH office.

He holds a degree from Central Michigan University in Sales & Marketing.

Favorite Book: Extreme Ownership Jocko Willink & Leif Babin
Favorite Team: Michigan Wolverines
Inspirational Quote: There is no substitute for hard work. Thomas A. Edison