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)
Job Summary:
This position is responsible for managing and developing a team of customer experience reps by providing daily support through feedback and coaching, as well as on regular basis vs performance KPI’s. This position is responsible for ensuring quality standards and SOPs are met and followed through all channels of communication. The Customer Experience Supervisor will also support Customer Experience through managing task volume and assigning tasks as needed to ensure service levels are being met. Updating SOPs and reporting of trends to leadership team is also part of your role. You also enjoy supporting Customer Experience by performing daily Customer Experience tasks.
Position Responsibilities:
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