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. Being an Appeal Resolution Manager allocates team resources to ensure an effective and balanced case workload. Applies industry standards and uses best practices in the preparation of legal briefs. Additionally, Appeal Resolution Manager may represent the organization at hearings. Requires a bachelor's degree. Typically reports to a senior manager or head of a unit/department. The Appeal Resolution Manager 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. To be an Appeal Resolution Manager 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. (Copyright 2024 Salary.com)
Team Manager, Complaint Resolution - Hybrid
In compliance with the company policies and procedures, the purpose of the Team Manager, Complaint Resolution is to lead a high functioning Complaints Resolution team and provide an unmatched experience for our customers. The Team Manager, Complaint Resolution is responsible for leading the complaints management processes, ensuring complaints are resolved accurately within set SLAs, and reporting on complaint trends. This role will also provide support to the Customer Experience team for 2nd shift and in the absence of a team manager.
Essential Functions
Required Education and Experience
Physical Demands
While performing the duties of this job, the employee is frequently required to sit, stand, walk, visualize, talk, hear, and handle or touch objects or controls. The employee may occasionally lift, push, or pull up to 20 pounds.
This position is an office-based position where you must be able to sit for long periods of time. The employee will be working on a computer 90% of the time.
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