Appeal Resolution Manager jobs in Passaic, NJ
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
- HBSI
-
Denville, NJ
FULL_TIME
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OverviewAccount Resolution SpecialistFacility Prime Healthcare Management Inc
Location US-NJ-Denville ID 2024-158827 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.
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 believe that all persons are entitled to equal employment opportunity and does not discriminate against qualified employees or applicants because of race, color, national origin, ancestry, sex, marital status, child birth or related medical condition or any other protected category as defined by State or Federal Law. We are an equal opportunity employer and do not discriminate against applicants due to veterans status, disability, race, gender or other protected characteristics. - 3 Days Ago
- Garage Clothing - Store Manager - Willowbrook Mall...
-
Wayne, NJ
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...
- 15 Days Ago
- Store Manager - Garage Clothing - Willowbrook Mall...
-
Wayne, NJ
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...
- 5 Days Ago
- Garage Clothing - Co Manager - Willowbrook Mall -...
-
Wayne, NJ
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...
- 6 Days Ago
- Dunkin' | QSR Little Falls LLC
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Little Falls, NJ
FULL_TIME
- As a Dunkin' franchisee, we are committed to our employees as much as we are committed to our customers. We value hardworking and enthusiastic employees and we make it a priority to ensure their succe...
- 8 Days Ago
- Subway - Independently Owned and Operated
-
Wayne, NJ
FULL_TIME
- System generated job type. Please do not delete or amend this job or job code
- 17 Days Ago
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- Passaic, NJ
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0 Appeal Resolution Manager jobs found in Passaic, NJ area
- PNC Financial Services Group, Inc.
-
Hackensack, NJ
- **Assistant Branch Manager** location Hackensack, New Jersey, United States of America category Branch Banking Full time...
- 4/18/2024 12:00:00 AM
- Harvey Nash
-
Montville, NJ
- Title: Mechanical Assembler Type: CTH Location: Montville, NJ US citizens and Green Card Holders and those authorized to...
- 4/18/2024 12:00:00 AM
- Prinston Pharmaceutical Inc.
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Somerset, NJ
- Job description Prinston Pharmaceutical Inc. ABOUT US Prinston Pharmaceutical, Inc. is a fully integrated pharmaceutical...
- 4/17/2024 12:00:00 AM
- The Goodkind Group, LLC
-
New York, NY
- Shift: Days Hours: 8:30AM - 5:00PM Status: Full-Time Hybrid (3 Days On-Site) Pay: $125,000 - $135,000 Job Summary: The R...
- 4/17/2024 12:00:00 AM
- The Goodkind Group, LLC
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New York, NY
- Risk Manger – Healthcare – Far Rockaway, NY $123-133k – Risk Manager - Healthcare needed to work at a medical facility i...
- 4/16/2024 12:00:00 AM
- PitchBook Data, Inc
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New York, NY
- At PitchBook we work to provide global professionals with comprehensive data on the entire venture capital, private equi...
- 4/16/2024 12:00:00 AM
- Peer Consulting Resources Inc.
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New York, NY
- Job Title: Public Safety & Emergency Management (PSEM) Project Manager Location: Brooklyn, NY (Hybrid, 3 days in office)...
- 4/16/2024 12:00:00 AM
- Gotham Technology Group
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Montvale, NJ
- We are a privately held technology consulting firm with 20+ years of solid performance and growth. We service corporate ...
- 4/15/2024 12:00:00 AM
About Passaic, New Jersey
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