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)
Overview
Claims Resolution Specialist
Starting at $17.50 per hour
On-Site
Hybrid Schedule Possible After 90 Day Probationary Period)
Do you enjoy puzzles and research? Are you results-oriented? If so, our Claims Resolution Specialist position may be a phenomenal career for you within Select Medical! Our dynamic team has the responsibility of resolving outstanding insurance claims so that our patients are not impacted.
We offer an exceptional employee experience, full-time hours, full benefits, paid training, and advancement opportunities.
Our team offers flexible, first shift, Monday through Friday schedules. This would include two fifteen minute breaks and one half-hour lunch.
We allow for casual work attire, jeans are our norm!
Responsibilities
Investigate and follow-up on all open balances for accounts that have received a payment or denial, or that are greater than 30 days from billing.
Contact responsible party to establish reason for non-payment document in system all verbal and written communication relative to open account balance, and institute timely follow-up with responsible party as a result of last contact to assure progress in resolving account with payment.
Qualifications
Required :
Preferred :
Additional Data
Your benefits as a Claims Resolution Specialist :
Select Medical strives to provide our employees with a solid work-life balance, as we understand that happy employees have both fulfilling careers and fulfilling lives beyond our doors.
Working Conditions / Physical Demands :
Select Medical is committed to having a workforce that reflects diversity at all levels and is an equal opportunity employer.
Qualified applicants are considered for employment, and employees are treated during employment without regard to race, color, religion, national origin, citizenship, age, sex, sexual orientation, gender identity, marital status, ancestry, physical or mental disability, veteran status, or any other characteristic protected under applicable law.
Select Medical is an EOE
Last updated : 2024-04-24
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