Appeal Resolution Manager jobs in Reno, NV

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)

T
Associate Client Resolution Coordinator
  • The Pasha Group
  • Reno, NV FULL_TIME
  • Job Summary
    The Associate Client Resolution Coordinator is responsible for settlement of client resolution issues in accordance with established program criteria.
    Primary Objectives
    • Timely, accurate, and complete execution of assigned responsibilities.
    • Accurate, timely, and thorough entry of records in proprietary systems.
    • Effective communication and collaboration with service members, vendors, and Transportation Service Providers (TSP).
    Duties and Responsibilities
    • Maintain department KPIs and accuracy ratings as defined by the department.
    • Enter voucher payable information into various computer systems.
    • Perform typing, faxing, mail distribution, phone messaging, and other office related duties as required.
    • Update tasks daily in the claims system.
    • Perform entry and updates of shipment information as needed.
    • Receive and respond to customer calls and correspondence, provide excellent service, and escalate concerns as needed.
    • Maintain timely contact with customers.
    • Accurately invoice customer shipments using multiple invoicing schedules and systems.
    • Update schedule, logs, and tasks daily.
    • Other duties as assigned.
    QUALIFICATIONS
    To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
    Required Education
    • High school diploma or equivalent (HSED) required
    Required Work Experience
    • 1 year of Customer Service related work experience
    Preferred Work Experience
    • Claims experience preferred
    Required Knowledge, Skills and Abilities
    • Good quantitative, analytical thinking, and problem solving skills.
    • Strong data entry skills with a typing speed of 35 WPM.
    • Business communication skills (verbal, written, interpersonal and listening skills)
    • Ability to perform basic math calculations including multiplication and percentages.
    • Ability to work as an individual contributor and as a valued participant in a team based environment.
    • Demonstrated ability to maintain confidentiality with tact and discretion.
    • Excellent customer service skills with the ability to develop effective professional relationships.
    • Good organizational and attention to detail skills.
    • Demonstrated proficiency with Microsoft Office products at the following levels:
    • Excel, Word, Outlook: Basic level of skill
    Preferred Knowledge, Skills and Abilities
    • Intermediate Microsoft Office skills (SharePoint, Outlook, Excel) preferred.
    PHYSICAL DEMANDS, WORK ENVIRONMENT, AND TRAVEL
    Physical Demands
    The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
    Hear and speak with sufficient clarity to understand and engage in telephonic information exchange; hear and understand verbal instructions; give and receive information verbally in person or via communication device - Often
    Walk/travel within office environment, crouch/bend to access floor-level storage - Often
    Use hands/fingers to operate office equipment, type/complete data input, write - Often
    Reach with hands, arms; lift, move and manipulate objects weighing up to 20 pounds - Regularly
    Sight sufficient to read instructions, documents, and screen-based information - Often
    Use hands/fingers to manipulate and file documents, folders, small objects - Regularly
    Working Environment
    This role requires work that may involve the following environmental conditions:
    • Corporate office environment
    • Work days and hours may vary to accommodate operations.
    COMPETENCIES
    Delivers Results Rigorously drives self and others to achieve high levels of individual and organization performance.
    Practices our Values Supports and models The Pasha Way; conduct reflects Excellence, Honesty, Integrity, Innovation and Teamwork.
    Focuses on the Customer & Market Continuously evaluates what is important to the customer/client and develops products or solutions that exceed expectations.
    Makes Sound Business Decisions Makes timely and well-informed decisions that advance critical priorities, capitalize on new opportunities, and resolve problems.
    Screening Requirements
    Background Checks

    Must be fully vaccinated against COVID-19.

    The information included in this description has been designed to indicate the general nature and level of work performed by employees within this classification.
    It is not designed to contain or be interpreted as a comprehensive or exhaustive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job.

    The applicable salary range is aligned to one of 5 zones according to a cost of labor index for the geographic location of the role. Starting pay for the successful applicant will depend on a variety of job-related factors, which may include related experience, education and training, location, business needs, or market demands. The expected salary range for this role is set forth below. Ranges may be modified in the future.
    Zone 3: $18.00 - $20.50
  • 7 Days Ago

P
Medical Management Resolution Specialist
  • Prominence Health
  • Reno, NV FULL_TIME
  • Responsibilities: Job Summary: The Medical Management Resolution Specialist (non-clinical staff) is responsible for monitoring the daily operations with the Medical Management Department, ensuring com...
  • 1 Month Ago

G
Manager
  • GALAXY SPARKS LLC
  • Sparks, NV FULL_TIME
  • DescriptionThank you for your interest in Galaxy Theatres. Here at Galaxy we are always looking for energetic, people-oriented individuals to join our team. We offer a fun, fast-paced environment in o...
  • 20 Days Ago

P
Manager
  • Pinnacle Bank / Bank of Colorado
  • Reno, NV FULL_TIME
  • Are you an experienced manager with demonstrated success driving sales goals and providing an amazing customer experience? Are you passionate about building teams, developing talent, and helping peopl...
  • 10 Days Ago

P
Manager
  • Panera Bread
  • Reno, NV FULL_TIME
  • Come Join Panera Bread- an award-winning leader in the restaurant industry and employer of choice for 2022! What's in it for you?A comprehensive benefit package including health, dental and visionPaid...
  • 14 Days Ago

J
Manager
  • Jimmy John's
  • Sparks, NV FULL_TIME
  • Manager runs shift of 8-10 hours per day. Manager is responsible for opening store, prepping ingredients vegetables, and making bread(s) for shifts; must manage fresh bread production throughout shift...
  • 25 Days Ago

Filters

Clear All

  • Filter Jobs by companies
  • More

0 Appeal Resolution Manager jobs found in Reno, NV area

J
Supply Chain Department Mgr
  • JCPenney
  • Reno, NV
  • Supply Chain Operations Manager Primary Responsibilities: Leads the department Associates by creating/sharing a common v...
  • 4/24/2024 12:00:00 AM

C
Assistant Project Manager
  • Centurion Selection
  • Reno, NV
  • Key Responsibilities: Subcontractor Buyout: Assist in the selection and procurement of subcontractors by soliciting bids...
  • 4/24/2024 12:00:00 AM

S
Human Resources Business Partner
  • SK Food Group Inc
  • Reno, NV
  • Hungry for a new career? Imagine...working for a company that knows that its people are the key to its success in the ma...
  • 4/24/2024 12:00:00 AM

R
Business Development Manager
  • RestoPros of Reno-Tahoe
  • Reno, NV
  • Job Description Job Description We are seeking an outgoing and customer service-oriented relationship manager to join ou...
  • 4/24/2024 12:00:00 AM

C
Assistant Project Manager
  • Centurion Selection
  • Reno, NV
  • Key Responsibilities: Subcontractor Buyout: Assist in the selection and procurement of subcontractors by soliciting bids...
  • 4/23/2024 12:00:00 AM

S
Human Resources Business Partner
  • Sk Food Group Inc
  • Reno, NV
  • Hungry for a new career? Imagine...working for a company that knows that its people are the key to its success in the ma...
  • 4/22/2024 12:00:00 AM

B
Associate Attorney
  • Bremer Whyte Brown & O'Meara, LLP
  • Reno, NV
  • Job Description Job Description Are you an ambitious and skilled attorney seeking an exciting new opportunity to make a ...
  • 4/21/2024 12:00:00 AM

I
Data Entry Clerk
  • Infosys Bpm
  • Reno, NV
  • Job description In the role of Process Associate, you will execute transactions as per prescribed guidelines and timelin...
  • 4/21/2024 12:00:00 AM

Reno (/ˈriːnoʊ/ REE-noh) is a city in the U.S. state of Nevada, located in the northwestern part of the state, approximately 22 miles (35 km) from Lake Tahoe. Known as "The Biggest Little City in the World", Reno is known for its casino industry. It is the county seat of Washoe County. The city sits in a high desert at the foot of the Sierra Nevada and its downtown area (along with Sparks) occupies a valley informally known as the Truckee Meadows. The city is named after Union Major General Jesse L. Reno, who was killed in action at the Battle of South Mountain on Fox's Gap. Reno, with an esti...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Manager jobs
$94,023 to $122,195
Reno, Nevada area prices
were up 2.5% 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