| Appeal Resolution Manager Job Description |
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| The following is a full job description for Appeal Resolution Manager. Here are the requirements and responsibilities for Appeal Resolution Manager along with statistics. If after reading this page you determine that Appeal Resolution Manager is not the position you are looking for, you may want to try one of these similar titles: Appeal Resolution Senior Manager, Appeal Resolution Nurse, Appeal Resolution Supervisor, Appeal Resolution Specialist, Appeal Resolution Senior Specialist, Conflicts Manager, IT Project Management and Delivery Manager, DevOps Engineering Manager, Solution Architecture Manager |
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| Requirements and Responsibilities For Appeal Resolution Manager |
| Manages the grievance process to review, investigate, document, process, negotiate, and resolve disputed medical, insurance, and other claims. Oversees work activity that is compliant with all regulatory guidelines and policy protocols. Allocates team resources to ensure an effective and balanced case workload. Applies industry standards and uses best practices in the preparation of legal briefs. May represent the organization at hearings. Requires a bachelor's degree. Typically reports to a senior manager or head of a unit/department. Manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. |
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| Also referred to as: Grievance and Appeals Resolution Manager |
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| Similar Jobs: Appeal Resolution Senior Manager, Appeal Resolution Nurse, Appeal Resolution Supervisor, Appeal Resolution Specialist, Appeal Resolution Senior Specialist, Conflicts Manager, IT Project Management and Delivery Manager, DevOps Engineering Manager, Solution Architecture Manager |
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| Level of Education: Appeal Resolution Manager Salaries with a Bachelor's Degree, Appeal Resolution Manager Salaries with a Master's Degree or MBA, Appeal Resolution Manager Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Edu., Gov't. & Nonprofit, Healthcare, Insurance | |
