Appeal Resolution Manager jobs in Pine Bluff, AR

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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Monitoring specialist
  • HealthCare Resolution Services
  • Bluff, AR FULL_TIME
  • JOB DESCRIPTION :

    Delivers remote patient monitoring and tele-health solutions for healthcare providers throughout the US. Our patient engagement software and services enable physicians to monitor and manage their patients' chronic conditions between office visits without investing in additional staff or money.

    By combining state of the art technology with a long history of expertise in the healthcare industry, HCRS & MagnatelMD are transforming medical practices.

    HCRS & MagnatelMD needs Medical Assistants to manage patients with chronic conditions by enrolling them in our remote patient monitoring program.

    The device provided transmits their medical data remotely. As the Patient Care Assistant, you contact the patient regularly to review their medical data received.

    JOB SKILLS :

    • Remain up-to date of CMS regulations.
    • Educate and encourage patient on program.
    • Provide onsite or scheduled group, and / or individual training sessions for potential patients.
    • Document patient conversation and instructions, orders, or recommendations clearly and concisely in the EMR.
    • Enroll patients into the Remote Patient Monitoring Program that have been referred to by provider or generated from the EMR.
    • Review patient data regularly and call patients on from the Monitoring platform; priority is given to red flag symptoms and non- compliant patients.

    Escalating trends of concern.

    • Educate patients on self-management skills and goal setting. These are patients with chronic conditions such as : Diabetes, CHF, COPD / Asthma, Hypertension, CAD,
    • Establish and maintain positive relationships with all internal and external customers.
    • Acts as a liaison for assigned patients with physicians' office.
    • Utilize Motivational Interviewing or other behavior change techniques to coach and assist the patient with self-management.
    • Engage patients to collaborate on optimal management of their chronic conditions.
    • Communicates with providers and staff regarding patient needs and follows up as appropriate.
    • Maintains compliance with standards, competencies, policies and procedures, proper documentation in the electronic medical record.
    • Provide inventory management to all medical equipment.
    • Provide weekly reports of patient and platform results.
    • Possible travel between provider's offices to provide support to teammates.
    • Performs other duties as required.
    • Stay in compliance with program by utilizing reimbursable activities with the patients which include patient's use of their device daily and time spent interacting with the patient in person or via telephone.

    Additional ways to communicate to patient are available as well.

    MINIMUM QUALIFICATIONS :

    • A Certified Medical Assistant
    • At minimum of two (2) years of experience in a clinical setting
    • Experience with Microsoft 365, Teams, and electronic medical records systems such as : E-clinical, Athena or NextGen
    • Ability to work independently with minimal direction.
    • Exceptional critical thinking skills
    • Extraordinary attention to detail
    • Must act with honesty and integrity.
    • Great time management
    • Great public speaking skills a plus
    • Last updated : 2024-04-07

  • 8 Days Ago

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Senior Manager – Human Resources - Sheridan, AR
  • Signode -Senior Manager – Human Resources
  • Sheridan, AR FULL_TIME
  • Senior Manager – Human Resources - Sheridan, AR Apply Now Description/Job Summary Our Brands Protect Your BrandsSignode is a leading transit-packaging provider with a proud tradition of offering a ran...
  • Just Posted

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Manager, Production
  • General Dynamics
  • Hampton, AR FULL_TIME
  • Manager, Production Job Locations US-AR-Hampton Requisition ID 2024-31185 Position Type Full Time Position Classification On-Site Job Function Manufacturing Overview Manufactures sufficient quantities...
  • 8 Days Ago

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Assistant Manager
  • Sonic - Esch Group Management Inc.
  • White, AR FULL_TIME
  • The Job:As a SONIC Drive-In Assistant General Manager, you are responsible for overseeing and managing the daily operations of the Drive-In in conjunction with the General Manager to provide quality f...
  • 8 Days Ago

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Hourly Manager
  • FLIS Management
  • Bluff, AR FULL_TIME
  • JOB TITLE: Hourly Manager REPORTS TO: General Manager (GM) DEPARTMENT: Operations RATE TYPE: Non-Exempt JOB SUMMARY The Hourly Manager directs team, ensures excellent customer service and operations e...
  • 8 Days Ago

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Production Manager
  • Impact Solutions Inc
  • Stuttgart, AR FULL_TIME
  • The successful candidate will ..... have large plant experience (600 persons or larger) experience in Metal Fabrication or Machining or Assembly strong in lean manufacturing has managed supervisors op...
  • 8 Days Ago

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0 Appeal Resolution Manager jobs found in Pine Bluff, AR area

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Power & Recovery Process Manager
  • Pactiv Evergreen
  • Pine Bluff, AR
  • Overview: Pactiv Evergreen Inc. (NASDAQ: PTVE) is a leading manufacturer and distributor of fresh foodservice and food m...
  • 4/18/2024 12:00:00 AM

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IE Planner
  • Pactiv Evergreen
  • Pine Bluff, AR
  • Overview: OVERVIEW Pactiv Evergreen Inc. (NASDAQ: PTVE) is a leading manufacturer and distributor of fresh foodservice a...
  • 4/18/2024 12:00:00 AM

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E&I Process Manager
  • Pactiv Evergreen Inc.
  • Pine Bluff, AR
  • Pactiv Evergreen Inc. (NASDAQ: PTVE) is a leading manufacturer and distributor of fresh foodservice and food merchandisi...
  • 4/18/2024 12:00:00 AM

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Surveillance Operator
  • SARACEN DEVELOPMENT LLC
  • Pine Bluff, AR
  • Job Description Job Description SUMMARY: This position is responsible for protecting Company assets and performing surve...
  • 4/18/2024 12:00:00 AM

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Quality Technical Services Manager
  • Pactiv Evergreen
  • Pine Bluff, AR
  • Overview: Pactiv Evergreen Inc. (NASDAQ: PTVE) is a leading manufacturer and distributor of fresh foodservice and food m...
  • 4/17/2024 12:00:00 AM

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E&I Process Manager
  • Pactiv Evergreen
  • Pine Bluff, AR
  • Overview: Pactiv Evergreen Inc. (NASDAQ: PTVE) is a leading manufacturer and distributor of fresh foodservice and food m...
  • 4/16/2024 12:00:00 AM

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Manufacturing Process Engineer I
  • Pactiv Evergreen
  • Pine Bluff, AR
  • Overview: Pactiv Evergreen Inc. (NASDAQ: PTVE) is a leading manufacturer and distributor of fresh foodservice and food m...
  • 4/15/2024 12:00:00 AM

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Quality Technical Services Manager
  • Pactiv Evergreen
  • Pine Bluff, AR
  • Overview: Pactiv Evergreen Inc. (NASDAQ: PTVE) is a leading manufacturer and distributor of fresh foodservice and food m...
  • 4/15/2024 12:00:00 AM

Pine Bluff is the tenth-largest city in the state of Arkansas and the county seat of Jefferson County. It is the principal city of the Pine Bluff Metropolitan Statistical Area and part of the Little Rock-North Little Rock-Pine Bluff Combined Statistical Area. The population of the city was 49,083 in the 2010 Census with 2017 estimates showing a decline to 42,984. The city is situated in the Southeast section of the Arkansas Delta and straddles the Arkansas Timberlands region to its west. Its topography is flat with wide expanses of farmland, consistent with other places in the Delta Lowlands....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Manager jobs
$83,732 to $108,821
Pine Bluff, Arkansas area prices
were up 1.2% from a year ago

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