Appeal Resolution Manager jobs in Appleton, WI

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)

A
Team Manager, Complaint Resolution - Hybrid
  • Aqua Finance
  • Schofield, WI FULL_TIME
  • 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

    • Lead a high performing complaints resolution team to deliver exemplary customer experience.
    • Review, assign, and provide supervision of all complaint resolution activity to ensure compliance with regulatory requirements, specific resolution procedures, and in accordance with applicable laws.
    • Manage team’s performance by tracking and analyzing improvement opportunities and effectively coaching the team as needed.
    • Track, report, and analyze SLA performance on a daily, weekly, and monthly basis to ensure complaints are closed within the set SLAs.
    • Execute, maintain, and enhance the complaint management program to ensure adequate processes are in place for identifying, logging, and managing complaints.
    • Complete ad hoc root cause investigation of complaints escalated to the executive team and regulatory bodies.
    • Coordinate with AVP-Customer Complaint Management on team performance, complaints, and resolution trends.
    • Collaborate with Dealer Oversight, Sales, Compliance, and Legal teams to find agreeable resolutions for complaints and address complaints/ trends.
    • Lead daily/weekly/monthly meetings with cross-functional teams to discuss emerging trends and tactical action plans.
    • Assist in the ongoing development and improvement of the Complaints Resolution group.
    • Ongoing training of current and new team members.
    • Monitor and manage day to day responsibilities of the Complaints Resolution team.
    • Support Team Manager, Customer Experience with answers to complex customer questions, requests, concerns, and complaints.
    • Answer incoming manager escalation calls.
    • Solve customer questions, requests, concerns, and complaints.
    • Communicate effectively and professionally with customers and employees both written and verbally.
    • Responsible for onsite managerial support including office operations, safety coordination, and facilities coordination
    • Perform other duties as assigned

    Required Education and Experience

    • High School Diploma or GED equivalent required.
    • Bachelor’s degree preferred.
    • 5 years complaint resolution or accounts/claims investigation experience required.
    • 3 years leadership experience in the financial industry preferred.
    • Bilingual (English and Spanish) candidates strongly preferred.
    • Ability and willingness to provide excellent customer service to resolve problems, answer questions, and manage difficult situations that arise.
    • Strong research and analytical skills, with attention to detail.
    • Strong problem-solving skills, with the ability to seek out and offer business-oriented and customer-oriented solutions.
    • Ability to prioritize and manage multiple tasks with a high level of efficiency and flexibility.
    • Ability to use a computer, fax, or telephone application to manage large amounts of information, including creating and editing simple databases, systems, and software by inputting data, retrieving specific documents, and creating reports to communicate information.
    • Proficient in the utilization of Microsoft Office Suite.
    • Attention to detail and accuracy required.
    • Excellent verbal and written communication skills required.

    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.

  • 18 Days Ago

S
Manager
  • Supple Group - Fratellos
  • Appleton, WI FULL_TIME
  • Are you looking for that next step? Great Base Salary, Bonus, Vacation, 75% of Premium on insurance. Opportunity for growth. 2 days off a week.joining a team of 2 very qualified senior managers. Join ...
  • 2 Days Ago

A
Manager
  • Altitude Trampoline Park
  • Appleton, WI PART_TIME
  • INTRODUCTION Altitude Trampoline Park is looking for a fun-loving, fast-paced, goal-oriented leader. If you are independent, opinionated, and looking to run a business unlike any other, we have the jo...
  • 10 Days Ago

O
Manager
  • Our Team
  • Appleton, WI FULL_TIME
  • Role PurposeAssist in leading restaurant managers and team members in the execution of an excellent guest experience resulting in increasing guest counts, sales and MOP growth. Ensures decisions and a...
  • 14 Days Ago

F
Manager
  • Fox River Brewery and Restaurant - Appleton
  • Appleton, WI FULL_TIME
  • Supervises dining room operation and coordinates food delivery. Supervises and trains employees, confers with kitchen and other personnel to plan events and related activities. Estimates beverage cost...
  • 14 Days Ago

F
Manager
  • Fox River Brewery Waterfront Restaurant and...
  • Oshkosh, WI FULL_TIME
  • Supervises dining room operation and coordinates food delivery. Supervises and trains employees, confers with kitchen and other personnel to plan events and related activities. Estimates beverage cost...
  • 18 Days Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

0 Appeal Resolution Manager jobs found in Appleton, WI area

T
RN Care Manager - PRN
  • Thedacare
  • Appleton, WI
  • Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion t...
  • 3/28/2024 12:00:00 AM

T
RN Care Manager
  • Thedacare
  • Appleton, WI
  • Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion t...
  • 3/28/2024 12:00:00 AM

W
Pharmacist- Sign-On Bonus and Relocation Available
  • WALGREENS
  • Appleton, WI
  • Job Objectives Provides pharmacy consulting services with empathy to patients regarding the effective usage of medicatio...
  • 3/27/2024 12:00:00 AM

S
FT Customer Support Specialist - Work From Home>
  • Stronghold
  • Menasha, WI
  • [Customer Service / Fully Remote] - Anywhere in U.S. / Competitive Pay / Email Only - As a Customer Support Specialist y...
  • 3/27/2024 12:00:00 AM

S
Store Manager - Assistant
  • Stein Garden Centers, Inc.
  • Kimberly, WI
  • Job Description Job Description Position: Assistant Store Manager Reports to: Store Manager Location: Kimberly, WI Type:...
  • 3/27/2024 12:00:00 AM

T
Material Planner
  • TreeHouse Foods, Inc.
  • Manawa, WI
  • Employee Type: Full time Location: WI Manawa DC Job Type: Supply Chain Planning Job Posting Title: Material Planner Abou...
  • 3/26/2024 12:00:00 AM

B
CDL Driver-Class A
  • Builders Firstsource, Inc.
  • De Pere, WI
  • AMAZING CAREERS FOUND HERE Our Team Members are the heartbeat of our Company, and we appreciate each and every one for t...
  • 3/26/2024 12:00:00 AM

O
Management Assistant - Highway Office
  • Outagamie County, WI
  • Appleton, WI
  • Salary : $49,358.40 - $53,934.40 Annually Location : Appleton, WI Job Type: Full-time Job Number: 2402886 Department: Hi...
  • 3/26/2024 12:00:00 AM

Appleton is a city in Outagamie (mostly), Calumet, and Winnebago counties in the U.S. state of Wisconsin. One of the Fox Cities, it is situated on the Fox River, 30 miles (48 km) southwest of Green Bay and 100 miles (160 km) north of Milwaukee. Appleton is the county seat of Outagamie County. The population was 72,623 at the 2010 census. Of this, 60,045 were in Outagamie County, 11,088 in Calumet County, and 1,490 in Winnebago County. Appleton is the principal city of the Appleton, Wisconsin Metropolitan Statistical Area, which is included in the Appleton-Oshkosh-Neenah, Wisconsin Combined Sta...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Manager jobs
$89,554 to $116,387
Appleton, Wisconsin area prices
were up 1.3% from a year ago

Appeal Resolution Manager in Racine, WI
General provisions on appeals are contained within CPR PD 52A.
December 03, 2019
Appeal Resolution Manager in Lancaster, PA
All appeals must be submitted in writing to the RC within ten academic calendar days after notification of the Dean of Students’ decision to accept or modify the recommendations resulting from the hearing.
February 06, 2020
Appeal Resolution Manager in San Diego, CA
The Coalition recommended that its members consider resolutions to request the Commission on Marine Resources to go forward with scientific and engineering studies regarding the Pearl River water resource project and creation of the Western Sound Special Management District.
January 16, 2020