Appeal Resolution Manager jobs in Columbus, OH

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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Senior Claims Resolution Specialist
  • Encova Insurance
  • Columbus, OH FULL_TIME
  • The salary range for this job posting is $53,787.00 - $86,059.00 annually bonus benefits

    The above represents the salary range for this job requisition. Ultimately, in determining your pay, we'll consider your location, education, experience, and other job-related factors. Your recruiter can share more information about the specific salary range during the hiring process.

    Encova Insurance has an immediate opening for a Senior Claims Resolution Specialist. This role will have the option to be fully remote but the ideal candidate will reside within our eastern claims territory. We will consider any well qualified candidate who resides within any state eligible for employment as shown on our careers page.

    In this role, you will report to a Manager, Casualty Claims.

    JOB OBJECTIVE:

    Investigate, evaluate, negotiate and settle commercial auto casualty claims and any related coverages within established best practices and applicable jurisdictional guidelines.

    ESSENTIAL FUNCTIONS:

    • Investigate, evaluate, settle and process claims primarily on the phone with limited in-person contact.
    • Handle claims including injury and third party property damage claims primarily under personal and commercial auto and garage, uninsured and underinsured motorists, homeowners liability and commercial liability coverages. Claims will generally range from low to moderate severity and may involve disability, wage loss and hospital treatment.
    • Handle automobile physical damage claims in conjunction with material damage appraisers.
    • Comply with the claims organization's policies, established best practices and jurisdictional guidelines.
    • Comply with practices and procedures for contact and communication, verification of coverages, determination of liability, investigation of losses, and determination of claims values, completion of forms and reports, negotiation and settlement of claims.
    • Comply with all state Fair Claims Practices acts and obtain state licensing as required.
    • Maintain competency in the use of multiple claims systems and manage efficient and effective follow-up practices.
    • Effectively investigate and handle a minimum average of 42 losses per month.

    OTHER FUNCTIONS:

    • Maintain an ongoing understanding of claims processes, procedures and systems, and keep current on fair claims practices laws, compliance issues, and business-related developments.
    • Make limited outside contacts at the discretion of the casualty team lead.
    • Perform other duties as assigned.

    KNOWLEDGE, SKILLS AND ABILITIES:

    • The candidate must have previous experience as a Claims Resolution Specialist or its equivalent in the industry.
    • Due to the complexity of the work performed and the frequency of customer contact, experience in successfully working with customers is strongly desirable.
    • Experience may be achieved in part or in full through the following: Sales experience, public service experience (e.g., police, social work) and/or other professional-level business experience.
    • Continuing education during the first two years of employment is preferred and may be obtained through the following: In-house claims training classes, The Institutes (Associate in Claims (AIC) and/or Chartered Property Casualty Underwriter (CPCU) designations) or other accredited insurance education provider.
    • This position requires excellent knowledge of all company commercial auto and commercial garage policies and coverages.
    • The individual must understand tort law, be familiar with medical terms and treatments, and be able to effectively negotiate settlements.
    • Demonstrate the skills and abilities listed in the Claims Resolution Specialist job description.
    • A college degree and the ability to read, write and speak fluent Spanish are strongly desired.


    This position has been evaluated in accordance with the Americans with Disabilities Act. Encova Insurance makes every effort to reasonably accommodate disabilities to permit performance of the essential functions and candidates who need such accommodation are encouraged to seek it. This description reflects the nature and level of work performed by associates in this position. It is not an all-inclusive inventory of duties, responsibilities and qualifications required. It provides an accurate overview of the work and skills needed to perform this position. Because job content may change from time to time, Encova Insurance reserves the right to add and/or delete functions from this job as it deems necessary for business reasons.

    Ready to join our team?
    At Encova Insurance, we firmly believe that our associates drive our company's success by delivering unrivaled service to our customers. With success in mind, we make an ongoing effort to provide an environment that offers challenging, stimulating and financially rewarding opportunities.

    Join us to discover a work experience where your diverse ideas will be met with enthusiasm - where you can learn and grow to your fullest potential.

    What you can expect from us
    Join our family of industry leaders, and let us reward you with a competitive salary, bonus and benefits package that includes but is not limited to: a 401(k), wellness programs, bonus incentive plans and flexible schedules, with an early close of the office every Friday. Additionally, Encova aspires to be an outstanding corporate citizen in all the markets we serve; we encourage and support associate participation in community initiatives through our foundations.

    Encova Insurance is an EOE/E-Verify employer.

     

  • 1 Day Ago

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Account Resolution Specialist-Collector
  • Weltman, Weinberg & Reis Co., LPA
  • Dublin, OH FULL_TIME
  • $2k Retention Bonus during your 1st year of Employment! We are currently looking for Account Resolution Specialists to join our Agency Collections team in Columbus/Dublin, Ohio. Our Account Resolution...
  • 15 Days Ago

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Garage Clothing - Store Manager - Easton Town Center - Columbus, OH
  • Garage clothing - Store manager - Easton Town...
  • Columbus, OH FULL_TIME
  • Seize the opportunity to join a global fashion retailer with two brands at the heart of its success, Garage and Dynamite, selected as one of Montreal's Top Employers 2020 and as one of Canada’s Top em...
  • 20 Days Ago

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Postdoctoral Fellow in High Resolution Retinal Imaging
  • The Ohio State University
  • Columbus, OH FULL_TIME,CONTRACTOR
  • A NIH funded Post Doctoral Scholar position is available in the laboratory of Dr. Nathan Doble in the College of Optometry/Department of Ophthalmology and Visual Science at The Ohio State University (...
  • 13 Days Ago

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Manager
  • Mazza's
  • Vernon, OH FULL_TIME
  • FullTime Manager Vacancy working for Mazza's at Mt Vernon OH
  • 20 Days Ago

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Manager
  • Flyers Pizza
  • Groveport, OH FULL_TIME
  • Flyers Pizza, a premier independent pizza restaurant since 1976, is seeking a dedicated and ambitious Manager to join our growing team. With 9 locations in Central Ohio and a 10th on the way, we offer...
  • 21 Days Ago

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0 Appeal Resolution Manager jobs found in Columbus, OH area

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Corporate Counsel
  • Jobs for Humanity
  • Columbus, OH
  • Company Description Jobs for Humanity is partnering with Safelite to build an inclusive and just employment ecosystem. T...
  • 3/28/2024 12:00:00 AM

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Real Estate Specialist
  • Franklin County Engineer's Office, OH
  • Columbus, OH
  • Salary : $74,817.60 - $103,355.20 Annually Location : Columbus, OH Job Type: Full Time Job Number: 2024-00002 Department...
  • 3/28/2024 12:00:00 AM

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Mobile Associate, Store-in-Store
  • T-Mobile
  • Columbus, OH
  • Be unstoppable with us! T-Mobile is synonymous with innovation-and you could be part of the team that disrupted an entir...
  • 3/28/2024 12:00:00 AM

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Account Executive - HR Solutions Sales
  • Paychex
  • Columbus, OH
  • Overview Selling Company's products and services by developing new clients and increasing the client base to increase pr...
  • 3/27/2024 12:00:00 AM

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VP, General Counsel - Remote US
  • Seamless.AI
  • Columbus, OH
  • The Opportunity: We are looking for a business-savvy lawyer who can balance risk, make sound judgments and win negotiati...
  • 3/26/2024 12:00:00 AM

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Paralegal - Housing Practice Group
  • Legal Aid of Southeast and Central Ohio
  • Columbus, OH
  • Legal Aid of Southeast and Central Ohio (LASCO)'s mission is to provide civil legal aid and advocacy to overcome unfairn...
  • 3/25/2024 12:00:00 AM

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Litigation Paralegal
  • Kisling, Nestico & Redick, LLC
  • Columbus, OH
  • The Litigation Paralegal position is responsible for investigating and researching facts and preparing documents to assi...
  • 3/25/2024 12:00:00 AM

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Maintenance Supervisor
  • Mauser Packaging Solutions
  • Columbus, OH
  • Position Summary: The Maintenance Manager is a key member of the facility leadership team who acts as a technical adviso...
  • 12/22/2023 12:00:00 AM

The confluence of the Scioto and Olentangy rivers occurs just north-west of Downtown Columbus. Several smaller tributaries course through the Columbus metropolitan area, including Alum Creek, Big Walnut Creek, and Darby Creek. Columbus is considered to have relatively flat topography thanks to a large glacier that covered most of Ohio during the Wisconsin Ice Age. However, there are sizable differences in elevation through the area, with the high point of Franklin County being 1,132 ft (345 m) above sea level near New Albany, and the low point being 670 ft (200 m) where the Scioto River leaves...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Manager jobs
$91,642 to $119,101
Columbus, Ohio 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