Appeal Resolution Manager jobs in Harlingen, TX
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)
Recently Added Appeal Resolution Manager jobs
- Harlingen Medical Center
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Harlingen, TX
FULL_TIME
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OverviewAccount Resolution SpecialistFacility Prime Healthcare Management Inc
Location US-TX-Harlingen ID 2024-155842 Category Business Professional Position Type Full Time Shift Days Job Type Non-Exempt ResponsibilitiesPrime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 45 hospitals and has more than 300 outpatient locations in 14 states providing more than 2.6 million patient visits annually. It is one of the nation's leading health systems with nearly 50,000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!
We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
QualificationsThe Specialist, Account Resolution is the lead responsible for the timely follow-up of Managed Care/Commercial accounts. Communicates clearly and efficiently by phone with health plans. Maintains productivity standards and reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts.
#LI-BF3
Connect With Us!EDUCATION, EXPERIENCE, TRAINING
1. Minimum of four years hospital managed care/commercial collector experience required.
2. Bachelor's degree or equivalent work experience preferred
3. Knowledge of contract interpretation
4. Familiar with hospital billing requirements
Not ready to apply? Connect with us for general consideration.
We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, sexual orientation, gender, gender identity, or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources:
hr-prime@primehealthcare.com - 1 Month Ago
- F&P BRANDS
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Raymondville, TX
OTHER
- Job Details Job Location: 13RAYM - Raymondville, TX Salary Range: Undisclosed DescriptionQualifications
- 21 Days Ago
- F&P BRANDS
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La Feria, TX
OTHER
- Job Details Job Location: 09LAFE - La Feria, TX Salary Range: Undisclosed DescriptionQualifications
- 21 Days Ago
- Urban Air Adventure Parks
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Harlingen, TX
FULL_TIME
- MANAGER JOB SUMMARY Urban Air Adventure Park is gearing up to ACTIVATE AWESOME. We are seeking a highly-motivated candidate to support our vision. In this role, the Manager motivates, instills account...
- Just Posted
- The Perfect Body
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Harlingen, TX
FULL_TIME
- Manage *MANAGER WANTED NOW* Our owners are CONSTANTIY buried with far too much to do, and I NEED to hire a detail oriented, organized manager for them ASAP.they own a rapidly growing gym out of Harlin...
- 10 Days Ago
- The Perfect Body Studio
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Harlingen, TX
FULL_TIME
- The Perfect Body in Harlingen, TX is looking for one manager to join our 11 person strong team. We are located on 614 South Ed Carey. Our ideal candidate is self-driven, punctual, and reliable. Benefi...
- 1 Month Ago
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0 Appeal Resolution Manager jobs found in Harlingen, TX area
- Under Armour
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Harlingen, TX
- Responsibilities The Assistant Store Manager supports the Store Manager in the daily operations of the store This includ...
- 4/24/2024 12:00:00 AM
- Walmart
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Harlingen, TX
- **Job Summary:** As a Shipping Associate at Walmart, you will be responsible for efficiently and accurately preparing me...
- 4/24/2024 12:00:00 AM
- Law Office of Zelene Zaleta PLLC
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McAllen, TX
- Job Description Job Description Law Office of Zelene Zaleta, PLLC is a prestigious law firm specializing in immigration ...
- 4/22/2024 12:00:00 AM
- Department Of The Treasury
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Harlingen, TX
- Duties WHAT IS THE LARGE BUSINESS AND INTERNATIONAL ACTIVITIESDIVISION? A description of the business units can be found...
- 4/22/2024 12:00:00 AM
- Department Of The Treasury
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Harlingen, TX
- Duties WHAT ARE THE APPEALS (AP), LARGE BUSINESS AND INTERNATIONAL (LB&I), SMALL BUSINESS SELF-EMPLOYED (SB/SE) AND TAX ...
- 4/22/2024 12:00:00 AM
- Scott & Associates Pc
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Brownsville, TX
- Embark on an exciting career journey with Scott & Associates, PC, a well-established multi-state legal recoveries law fi...
- 4/21/2024 12:00:00 AM
- Department Of The Treasury
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Harlingen, TX
- Duties WHAT IS THE TAX EXEMPT & GOVERNMENT ENTITIES (TE/GE) DIVISION? A description of the business units can be found a...
- 4/21/2024 12:00:00 AM
- Branch 53
-
Harlingen, TX
- Job Description Job Description Job Description: • Perform administrative duties, such as maintaining employee database ...
- 4/20/2024 12:00:00 AM
About Harlingen, Texas
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