Appeal Resolution Specialist jobs in Colorado Springs, CO

Appeal Resolution Specialist logs, tracks, and processes appeals and grievances. Sets up and maintains case files for each grievance and collects the information required by organizational policies and applicable regulations. Being an Appeal Resolution Specialist conducts research and coordination needed to evaluate, process, respond to, and refer or close appeals. May require an associate degree or equivalent. Additionally, Appeal Resolution Specialist typically reports to a supervisor. The Appeal Resolution Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be an Appeal Resolution Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)

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Director, Fraud Member Resolution
  • JobRapido
  • colorado, CO FULL_TIME
  • Why USAA? Let's do something that really matters.
    At USAA, we have an important mission: facilitating the financial security of millions of U.S. military members and their families. Not all our employees served in our nation's military, but we all share in the mission to give back to those who did. We're working as one to build a great experience and make a real impact for our members.
    We believe in our core values of honesty, integrity, loyalty, and service. They're what guides everything we do - from how we treat our members to how we treat each other. Come be a part of what makes us so special!
    As a dedicated Director, Fraud Member Resolution, you will oversee a team responsible for the development, implementation and oversight of programs that support effective Risk and compliance management in the first line of defense. Supports business leader adherence to the established Risk framework and ongoing supervision of business controls and is accountable for the development and mentoring of a high performing team responsible for Risk and control self-assessments, identifying control failures, facilitating Risk and compliance remediation, internal and external audits and regulatory exams, and monitoring the of first line of defense in an effort to minimize Risk exposures and strengthen the overall control environment.
    We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position can be based in one of the following locations: San Antonio, TX, Plano, TX, Phoenix, AZ, Colorado Springs, CO, Charlotte, NC, or Tampa, FL. Relocation assistance is not available for this position.
    This position can work remotely in the continental U.S. with occasional business travel.

    The Opportunity What you'll do:

    • Directs staff and initiatives that support Risk and control management programs, to include governance support, Risk oversight, Risk infrastructure development, Risk identification, quantification, aggregation, and emerging Risks.

    • Advises senior management and influences process change.

    • Builds and leads a high performing team of Risk and internal control professionals through recruitment, training, coaching, performance management and related managerial activities.

    • Handles consulting relationships with internal and external clients regarding budget and implementation results and Risk mitigation plans as appropriate.

    • Partners with key collaborators in the business and is responsible for the identification, assessment and documentation of Risks and controls, including Risks associated with new or modified products, services, distribution channels, regulations and/or third-party operations.

    • Reviews, communicates and recommends the development of governance policies and procedures in partnership with senior leaders to ensure appropriateness and adequacy versus industry best practices and regulatory requirements.

    • Provides counsel to business unit managers on Risk management issues and supports the evaluation of new product strategies on their impact to USAA's Risk profile.

    • Educates Risk owners on Risk/control best practices and may work with other lines of defense in the development and implementation of controls.

    • Innovates processes for collecting accurate and complete internal loss data from business areas.

    • Directs analysis and data mining initiatives that identify, validate, and lead emerging Risk exposures, as necessary.

    • Assists in the early identification of Risk trends by establishing and monitoring key performance and Risk indicators.

    • Oversees the preparation of key reports and communications and may present to governance committees, senior leaders, regulatory bodies and the USAA Board of Directors.

    • Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

    What you have:

    • Bachelor's Degree in Risk Management, Business, Finance or related field of study; OR 4 years of Financial Fraud experience (in addition to the minimum years of experience required) may be substituted in lieu of degree

    • 8 years of experience supporting Risk and/or compliance related activities in a financial services operating environment or other relevant industry; OR 8 years of experience in a relevant quantitative discipline; OR Advanced degree or designation in a Risk management or quantitative subject area, and 6 years of experience supporting Risk and/or compliance related activities; OR PhD in a Risk management or quantitative subject area, and 4 years of experience supporting Risk and/or compliance related activities.

    • 3 years of direct team lead or people management experience.

    • Knowledge of federal laws, rules, regulations, and applicable guidance to include: OCC Heightened Standards, BSA/AML, REG E, REG CC, UDAAP/UDAP, TILA/REG Z, SCRA, FCRA, MLA.

    What sets you apart:

    • Experience in Fraud at a Financial Institution

    • Strong influential written and verbal communication skills.

    • Expert knowledge of Microsoft Office

    • Issues Management experience

    • Working with Regulators

    • US military experience through military service or a military spouse/domestic partner

    The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.

    What we offer:

    Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. The salary range for this position is: $120,550-$230,400.

    Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.

    Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.

    For more details on our outstanding benefits, please visit our benefits page on

    Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.

    USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.


    About the Company:
    JobRapido



  • 3 Days Ago

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Fraud Member Resolution - Mid Level
  • JobRapido
  • colorado, CO FULL_TIME
  • Why USAA? Let's do something that really matters.At USAA, we have an important mission: facilitating the financial security of millions of U.S. military members and their families. Not all of our empl...
  • 3 Days Ago

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Fraud Member Resolution - Senior Level
  • JobRapido
  • colorado, CO FULL_TIME
  • Why USAA? Let's do something that really matters.At USAA, we have an important mission: facilitating the financial security of millions of U.S. military members and their families. Not all of our empl...
  • 4 Days Ago

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Specialist
  • Colorado Judicial Branch
  • Colorado, CO FULL_TIME
  • Specialist JOB CODE JD02862 LOCATION Colorado Springs / El Paso County DEPARTMENT Combined Court POSTED 10-Jul-2023 CLOSES 23-Jul-2023 POSITION NUMBER 21514 FTE LEVEL 1.0 POSITION INFORMATION Job Code...
  • 3 Days Ago

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Merchandiser Specialist
  • Acosta Group
  • Montrose, CO FULL_TIME
  • **Start your career with Premium.** \#WeArePremium **Merchandiser Specialist** **General Information** **Location:** MONTROSE, Colorado, 81401 **Ref #:** 35336 **Pay Rate:** $ 14.00 **Function:** Merc...
  • 9 Days Ago

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Brokerage Specialist
  • Cushman & Wakefield
  • Colorado, CO FULL_TIME
  • Job TitleBrokerage SpecialistJob Description SummaryThe Brokerage/Marketing Specialist will report to the Director of Operations and will serve as the support for a fee-earner and/or team. This positi...
  • 9 Days Ago

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0 Appeal Resolution Specialist jobs found in Colorado Springs, CO area

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Accounting Specialist
  • Mosaic
  • Canon City, CO
  • Mosaic serves more than 5,200 people in 13 states and 750 communities. Services are tailored to meet individual needs an...
  • 4/19/2024 12:00:00 AM

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Template Specialist
  • UCHealth
  • COLORADO SPRINGS, CO
  • Description Location: UCHealth Memorial Hospital Central, Colorado Springs Department: UCHlthMG Cardiology FTE: Full Tim...
  • 4/18/2024 12:00:00 AM

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Guest Service Expert>
  • Smashburger
  • Colorado Springs, CO
  • Smashburger - 9290 Highland Rdg Hts [Food Service / Crew Member / Team Member] As a Guest Service Expert at Smashburger,...
  • 4/18/2024 12:00:00 AM

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Guest Service Expert>
  • Smashburger
  • Castle Rock, CO
  • Smashburger - 4991 Factory Shops Blvd [Food Service / Crew Member / Team Member] As a Guest Service Expert at Smashburge...
  • 4/18/2024 12:00:00 AM

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Field Operations Specialist
  • Leidos
  • Colorado Springs, CO
  • Description Leidos is seeking a talented Field Operations Specialist, T-2, to join our diverse team and create unique so...
  • 3/15/2024 12:00:00 AM

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Field Operations Specialist
  • Leidos
  • Colorado Springs, CO
  • Description Leidos is seeking a talented Field Operations Specialist, T-2, to join our diverse team and create unique so...
  • 3/15/2024 12:00:00 AM

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Field Operations Specialist
  • Leidos
  • Colorado Springs, CO
  • Description Leidos is seeking a talented Field Operations Technical Lead, T-4, to join our diverse team and create uniqu...
  • 3/15/2024 12:00:00 AM

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Field Operations Specialist
  • Leidos
  • Colorado Springs, CO
  • Description Leidos is seeking a talented Field Operations Specialist, T-3, to join our diverse team and create unique so...
  • 3/15/2024 12:00:00 AM

Colorado Springs is a home rule municipality that is the largest city by area in Colorado as well as the county seat and the most populous municipality of El Paso County, Colorado, United States. Colorado Springs is located in the east central portion of the state. It is situated on Fountain Creek and is located 60 miles (97 km) south of the Colorado State Capitol in Denver. At 6,035 feet (1,839 m) the city stands over 1 mile (1.6 km) above sea level, though some areas of the city are significantly higher and lower. Colorado Springs is situated near the base of Pikes Peak, which rises 14,115 f...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Specialist jobs
$47,431 to $58,759
Colorado Springs, Colorado area prices
were up 2.3% from a year ago

Appeal Resolution Specialist in Colorado Springs, CO
As a Appeals Resolution Specialist, you will work directly with our Shared Service Centerproviding follow up to denied claims.
February 22, 2020
Appeal Resolution Specialist in Fort Smith, AR
Overcome objections that prevent payment of the claim and gain commitment forpayment through concise and effective appeal argument.
February 01, 2020
Appeal Resolution Specialist in Middlesex, NJ
Coordinate the overall process of complaint resolution, responding to all verbal and written complaints from members and/or providers relating to member eligibility and benefits, contract administration, claims processing, utilization management decisions, pharmacy and vision decisions.
January 25, 2020