Appeal Resolution Manager jobs in Colorado Springs, CO

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)

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Director, Fraud Member Resolution
  • JobRapido
  • colorado, CO FULL_TIME
  • Why USAA? Let's do something that really matters.
    At USAA, we have an important mission: facilitating the financial security of millions of U.S. military members and their families. Not all our employees served in our nation's military, but we all share in the mission to give back to those who did. We're working as one to build a great experience and make a real impact for our members.
    We believe in our core values of honesty, integrity, loyalty, and service. They're what guides everything we do - from how we treat our members to how we treat each other. Come be a part of what makes us so special!
    As a dedicated Director, Fraud Member Resolution, you will oversee a team responsible for the development, implementation and oversight of programs that support effective Risk and compliance management in the first line of defense. Supports business leader adherence to the established Risk framework and ongoing supervision of business controls and is accountable for the development and mentoring of a high performing team responsible for Risk and control self-assessments, identifying control failures, facilitating Risk and compliance remediation, internal and external audits and regulatory exams, and monitoring the of first line of defense in an effort to minimize Risk exposures and strengthen the overall control environment.
    We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position can be based in one of the following locations: San Antonio, TX, Plano, TX, Phoenix, AZ, Colorado Springs, CO, Charlotte, NC, or Tampa, FL. Relocation assistance is not available for this position.
    This position can work remotely in the continental U.S. with occasional business travel.

    The Opportunity What you'll do:

    • Directs staff and initiatives that support Risk and control management programs, to include governance support, Risk oversight, Risk infrastructure development, Risk identification, quantification, aggregation, and emerging Risks.

    • Advises senior management and influences process change.

    • Builds and leads a high performing team of Risk and internal control professionals through recruitment, training, coaching, performance management and related managerial activities.

    • Handles consulting relationships with internal and external clients regarding budget and implementation results and Risk mitigation plans as appropriate.

    • Partners with key collaborators in the business and is responsible for the identification, assessment and documentation of Risks and controls, including Risks associated with new or modified products, services, distribution channels, regulations and/or third-party operations.

    • Reviews, communicates and recommends the development of governance policies and procedures in partnership with senior leaders to ensure appropriateness and adequacy versus industry best practices and regulatory requirements.

    • Provides counsel to business unit managers on Risk management issues and supports the evaluation of new product strategies on their impact to USAA's Risk profile.

    • Educates Risk owners on Risk/control best practices and may work with other lines of defense in the development and implementation of controls.

    • Innovates processes for collecting accurate and complete internal loss data from business areas.

    • Directs analysis and data mining initiatives that identify, validate, and lead emerging Risk exposures, as necessary.

    • Assists in the early identification of Risk trends by establishing and monitoring key performance and Risk indicators.

    • Oversees the preparation of key reports and communications and may present to governance committees, senior leaders, regulatory bodies and the USAA Board of Directors.

    • Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

    What you have:

    • Bachelor's Degree in Risk Management, Business, Finance or related field of study; OR 4 years of Financial Fraud experience (in addition to the minimum years of experience required) may be substituted in lieu of degree

    • 8 years of experience supporting Risk and/or compliance related activities in a financial services operating environment or other relevant industry; OR 8 years of experience in a relevant quantitative discipline; OR Advanced degree or designation in a Risk management or quantitative subject area, and 6 years of experience supporting Risk and/or compliance related activities; OR PhD in a Risk management or quantitative subject area, and 4 years of experience supporting Risk and/or compliance related activities.

    • 3 years of direct team lead or people management experience.

    • Knowledge of federal laws, rules, regulations, and applicable guidance to include: OCC Heightened Standards, BSA/AML, REG E, REG CC, UDAAP/UDAP, TILA/REG Z, SCRA, FCRA, MLA.

    What sets you apart:

    • Experience in Fraud at a Financial Institution

    • Strong influential written and verbal communication skills.

    • Expert knowledge of Microsoft Office

    • Issues Management experience

    • Working with Regulators

    • US military experience through military service or a military spouse/domestic partner

    The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.

    What we offer:

    Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. The salary range for this position is: $120,550-$230,400.

    Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.

    Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.

    For more details on our outstanding benefits, please visit our benefits page on

    Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.

    USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.


    About the Company:
    JobRapido



  • 8 Days Ago

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Fraud Member Resolution - Mid Level
  • JobRapido
  • colorado, CO FULL_TIME
  • Why USAA? Let's do something that really matters.At USAA, we have an important mission: facilitating the financial security of millions of U.S. military members and their families. Not all of our empl...
  • 8 Days Ago

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Fraud Member Resolution - Senior Level
  • JobRapido
  • colorado, CO FULL_TIME
  • Why USAA? Let's do something that really matters.At USAA, we have an important mission: facilitating the financial security of millions of U.S. military members and their families. Not all of our empl...
  • 9 Days Ago

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Manager
  • Panera Bread
  • Colorado, CO FULL_TIME
  • Come Join Panera Bread- an award-winning leader in the restaurant industry and employer of choice for 2022! What's in it for you?A comprehensive benefit package including health, dental and visionPaid...
  • 15 Days Ago

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Manager
  • Subway - 40626-0
  • Woodland, CO FULL_TIME
  • $45,000 to $55,000 including tips based off experience. .As part of the Subway® Team, you as a Manager will focus on eight main things: Providing an excellent guest experience Ensuring that great food...
  • 15 Days Ago

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Manager
  • Subway - 23025-0
  • Colorado, CO FULL_TIME
  • As part of the Subway® Team, you as a Manager will focus on eight main things: Providing an excellent guest experience Ensuring that great food is prepared & servedKeeping our restaurants functional, ...
  • 15 Days Ago

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0 Appeal Resolution Manager jobs found in Colorado Springs, CO area

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Construction Superintendent
  • Nunn Construction
  • Colorado Springs, CO
  • Project Superintendent Colorado Springs, CO (Relocators Encouraged to Apply! Assistance Provided) $100,000 - $140,000 Ba...
  • 4/23/2024 12:00:00 AM

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Construction Project Manager
  • iiCON Construction
  • Colorado Springs, CO
  • Job Description Job Description Salary: $90,000 - $115,000 Annually DOE iiCON Construction is a progressive construction...
  • 4/23/2024 12:00:00 AM

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System Administrator - TS/SCI Required Poly Preferred
  • cFocus Software Incorporated
  • Colorado Springs, CO
  • Job Description Job Description cFocus Software is seeking a System Administrator to join our program in Colorado Spring...
  • 4/23/2024 12:00:00 AM

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Tax Manager
  • Stockman Kast Ryan + Company
  • Colorado Springs, CO
  • Job Description Job Description TAX MANAGER Location: Colorado Springs CO, Denver CO, or remote Compensation: $98,000-$1...
  • 4/23/2024 12:00:00 AM

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Client Services Representative
  • Ascend Clinical
  • Colorado Springs, CO
  • Job Description Job Description Client Services Representative (Clinical Laboratory-Call Center)Locations: Colorado Spri...
  • 4/23/2024 12:00:00 AM

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Campus Coordinator I (Client Relief Shelter)
  • Springs Rescue Mission
  • Colorado Springs, CO
  • Job Type Full-time Description How would you feel at the end of the workday to know you are serving a purpose bigger tha...
  • 4/22/2024 12:00:00 AM

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Safety & Security Officer
  • Springs Rescue Mission
  • Colorado Springs, CO
  • SUMMARY OF POSITION: Springs Rescue Mission considers every position one of ministry and a vital and valued part of our ...
  • 4/22/2024 12:00:00 AM

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Injury Examiner - various locations
  • USAA
  • Colorado Springs, CO
  • Why USAA? Lets do something that really matters. At USAA, we have an important mission: facilitating the financial secur...
  • 4/20/2024 12:00:00 AM

Colorado Springs is a home rule municipality that is the largest city by area in Colorado as well as the county seat and the most populous municipality of El Paso County, Colorado, United States. Colorado Springs is located in the east central portion of the state. It is situated on Fountain Creek and is located 60 miles (97 km) south of the Colorado State Capitol in Denver. At 6,035 feet (1,839 m) the city stands over 1 mile (1.6 km) above sea level, though some areas of the city are significantly higher and lower. Colorado Springs is situated near the base of Pikes Peak, which rises 14,115 f...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Manager jobs
$93,088 to $120,979
Colorado Springs, Colorado area prices
were up 2.3% from a year ago

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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.
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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.
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