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3 Emblemhealth Hourly Associate Jobs Hiring Near You

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What are the key skills and qualifications needed to thrive as an Hourly Associate, and why are they important?

To thrive as an Hourly Associate, you need basic math skills, reliability, and a high school diploma or equivalent is often preferred. Familiarity with point-of-sale (POS) systems, inventory management tools, or basic computer applications is usually required. Strong customer service, teamwork, and communication skills help you excel in fast-paced retail or service environments. These skills and qualities are important to ensure efficient operations, positive customer experiences, and a productive workplace.

What are some common challenges Hourly Associates face and how can they effectively manage them?

Hourly Associates often encounter challenges such as managing high workloads during peak hours, adapting to frequent task changes, and maintaining excellent customer service under pressure. Effective time management, clear communication with supervisors, and teamwork are essential for handling these situations successfully. Many employers also provide on-the-job training and encourage associates to seek guidance from experienced team members. By staying organized and proactive, associates can navigate these challenges and contribute positively to their team.

What is an Hourly Associate?

An Hourly Associate is an employee who is paid an hourly wage rather than a fixed salary. These positions are common in industries like retail, food service, and hospitality. Hourly Associates typically perform a variety of tasks such as assisting customers, stocking shelves, or maintaining store cleanliness. Their schedules can be flexible and may include evenings, weekends, or holidays depending on the employer’s needs.

What is the difference between Hourly Associate vs Retail Cashier?

AspectHourly AssociateRetail Cashier
CredentialsHigh school diploma or equivalent often requiredHigh school diploma or equivalent typically required
Work EnvironmentVaries across retail, warehouse, or service settingsPrimarily retail stores, customer service focused
Employer & Industry UsageCommon in retail, warehouse, hospitality sectorsPrimarily in retail stores, supermarkets, malls
Search & Comparison IntentOften searched for general retail roles or entry-level jobsSpecifically compared for retail customer service roles

While both roles involve working in retail environments and may require similar credentials, an Hourly Associate has a broader scope, working in various retail or service settings, whereas a Retail Cashier specializes in handling transactions and customer payments. Understanding these differences helps job seekers find the role that best matches their skills and career goals.

What other companies are hiring for Hourly Associate jobs?
What are the most popular jobs at Emblemhealth?
What are the most popular categories at Emblemhealth?
Infographic showing various Hourly Associate job openings at Emblemhealth in the United States as of May 2026, with employment types broken down into 2% As Needed, and 98% Full Time. Highlights an 76% Physical, and 24% Remote job distribution.
Expedited Appeals Specialist (Remote)

Expedited Appeals Specialist (Remote)

EmblemHealth

New York, NY • On-site, Remote

$48.60K - $83.16K/yr

Full-time

PTO

Posted 27 days ago

Job description

Summary of Position
  • Responsible for processing expedited appeals: those that are complex in nature, require multiple hand-offs, and tend to have extremely tight deadlines. Ensure accuracy and compliance within the constraints of extremely quick turnaround times. Perform end-to-end G&A processing; consistently operate in a fast-paced high-pressure environment. Monitor all aspects of the G&A process; ensure that members have appropriate access to care. Due to regulatory requirements and turn-around times of the Expedited Appeal unit, the Specialists are required to work weekends and holidays as the organization must maintain expedited appeal coverage 7 days a week, 365 days a year.

Principal Accountabilities
  • Independently perform triage function: review and evaluate appeal requests; identify and classify member and provider appeals. Using internal systems, determine eligibility, benefits, and prior activity related to the claims, payment, or service in question.
  • Provide verbal and written member and provider correspondence as needed for authorized representative or needed clinical information.
  • Conduct thorough investigations of all member and provider correspondence by analyzing all the issues presented and obtaining responses and information from internal and external entities. Validate the responses to ensure they address the issues and are supported by any contract stipulations, regulations, etc., as applicable.
  • Make critical decisions regarding research and investigation to appropriately resolve all inquiries; prepare cases for medical and administrative review detailing the findings of their investigation for consideration in the Plan's determination; make recommendations on administrative decisions by preparing detailed case summaries and reviewing all applicable benefit and contract materials; present findings and recommendations to appropriate parties for sign-off.
  • Serve as liaison with EmblemHealth departments, delegated entities, medical groups, and network physicians to ensure timely authorization effectuation and resolution of cases.
  • Perform necessary follow-up with responsible departments and delegated entities to ensure compliance.
  • Monitor hourly and daily pending reports and personal worklists, ensuring adherence to CMS, NCQA, DOH, NYS, Connecticut and Massachusetts regulatory requirements, as well as operational SLAs and department performance standards, thereby ensuring members' access to care.
  • Independently prepare well written, customized responses to all correspondence that appropriately and completely address the complainant's issue(s) and are structurally accurate. Responsible for ensuring responses are completed within the applicable regulatory timeframe.
  • Complete submission of case files and responses to entities such as DFS, DOH, AG and Maximus; ensure timely and appropriate response submissions.
  • Document final resolutions along with all required data to facilitate accurate reporting, tracking, and trending.
  • Identify workflow improvements and work with the team to recommend and implement change(s).
  • Provide recommendations to management regarding issue resolution, root cause analysis and best practices.
  • Serve as a point of escalation for problems, providing guidance and expertise to team members as well as helping to identify and address core business requirements.
  • May train, guide, and mentor new G&A Specialists.
  • Serve as a coach and mentor to the associates providing support and guidance in complex situations.
  • Maintain acceptable attendance standard with minimal unscheduled PTO.
  • Exceed median production and compliance standards for both case resolution and data requirements.
  • Perform other duties as directed, assigned, or required.

Qualifications
  • Bachelors' degree
  • 3 - 5+ years of related experience, preferably in the health industry and/or area of compliance
  • Additional related experience/specialized training may be considered in lieu of degree requirements
  • Extensive knowledge and experience in claims, enrollment, benefits, and member contracts
  • Ability to mentor specialists and to provide assistance on complex cases
  • Must be well versed in all aspects of the complaint, grievance and appeal process and be able to process all types of correspondence handled by Grievance and Appeals
  • Proficiency in MS Office (Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.)
  • Excellent product knowledge
  • Excellent prioritizing, organizing, time management, problem solving and analytical skills
  • Ability to work under pressure and deliver complete, accurate, and timely results
  • Leadership skills

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