Appeal Resolution Specialist jobs in Columbus, OH

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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Senior Claims Resolution Specialist
  • Encova Insurance
  • Columbus, OH FULL_TIME
  • The salary range for this job posting is $53,787.00 - $86,059.00 annually bonus benefits

    The above represents the salary range for this job requisition. Ultimately, in determining your pay, we'll consider your location, education, experience, and other job-related factors. Your recruiter can share more information about the specific salary range during the hiring process.

    Encova Insurance has an immediate opening for a Senior Claims Resolution Specialist. This role will have the option to be fully remote but the ideal candidate will reside within our eastern claims territory. We will consider any well qualified candidate who resides within any state eligible for employment as shown on our careers page.

    In this role, you will report to a Manager, Casualty Claims.

    JOB OBJECTIVE:

    Investigate, evaluate, negotiate and settle commercial auto casualty claims and any related coverages within established best practices and applicable jurisdictional guidelines.

    ESSENTIAL FUNCTIONS:

    • Investigate, evaluate, settle and process claims primarily on the phone with limited in-person contact.
    • Handle claims including injury and third party property damage claims primarily under personal and commercial auto and garage, uninsured and underinsured motorists, homeowners liability and commercial liability coverages. Claims will generally range from low to moderate severity and may involve disability, wage loss and hospital treatment.
    • Handle automobile physical damage claims in conjunction with material damage appraisers.
    • Comply with the claims organization's policies, established best practices and jurisdictional guidelines.
    • Comply with practices and procedures for contact and communication, verification of coverages, determination of liability, investigation of losses, and determination of claims values, completion of forms and reports, negotiation and settlement of claims.
    • Comply with all state Fair Claims Practices acts and obtain state licensing as required.
    • Maintain competency in the use of multiple claims systems and manage efficient and effective follow-up practices.
    • Effectively investigate and handle a minimum average of 42 losses per month.

    OTHER FUNCTIONS:

    • Maintain an ongoing understanding of claims processes, procedures and systems, and keep current on fair claims practices laws, compliance issues, and business-related developments.
    • Make limited outside contacts at the discretion of the casualty team lead.
    • Perform other duties as assigned.

    KNOWLEDGE, SKILLS AND ABILITIES:

    • The candidate must have previous experience as a Claims Resolution Specialist or its equivalent in the industry.
    • Due to the complexity of the work performed and the frequency of customer contact, experience in successfully working with customers is strongly desirable.
    • Experience may be achieved in part or in full through the following: Sales experience, public service experience (e.g., police, social work) and/or other professional-level business experience.
    • Continuing education during the first two years of employment is preferred and may be obtained through the following: In-house claims training classes, The Institutes (Associate in Claims (AIC) and/or Chartered Property Casualty Underwriter (CPCU) designations) or other accredited insurance education provider.
    • This position requires excellent knowledge of all company commercial auto and commercial garage policies and coverages.
    • The individual must understand tort law, be familiar with medical terms and treatments, and be able to effectively negotiate settlements.
    • Demonstrate the skills and abilities listed in the Claims Resolution Specialist job description.
    • A college degree and the ability to read, write and speak fluent Spanish are strongly desired.


    This position has been evaluated in accordance with the Americans with Disabilities Act. Encova Insurance makes every effort to reasonably accommodate disabilities to permit performance of the essential functions and candidates who need such accommodation are encouraged to seek it. This description reflects the nature and level of work performed by associates in this position. It is not an all-inclusive inventory of duties, responsibilities and qualifications required. It provides an accurate overview of the work and skills needed to perform this position. Because job content may change from time to time, Encova Insurance reserves the right to add and/or delete functions from this job as it deems necessary for business reasons.

    Ready to join our team?
    At Encova Insurance, we firmly believe that our associates drive our company's success by delivering unrivaled service to our customers. With success in mind, we make an ongoing effort to provide an environment that offers challenging, stimulating and financially rewarding opportunities.

    Join us to discover a work experience where your diverse ideas will be met with enthusiasm - where you can learn and grow to your fullest potential.

    What you can expect from us
    Join our family of industry leaders, and let us reward you with a competitive salary, bonus and benefits package that includes but is not limited to: a 401(k), wellness programs, bonus incentive plans and flexible schedules, with an early close of the office every Friday. Additionally, Encova aspires to be an outstanding corporate citizen in all the markets we serve; we encourage and support associate participation in community initiatives through our foundations.

    Encova Insurance is an EOE/E-Verify employer.

     

  • 1 Day Ago

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Account Resolution Specialist-Collector
  • Weltman, Weinberg & Reis Co., LPA
  • Dublin, OH FULL_TIME
  • $2k Retention Bonus during your 1st year of Employment! We are currently looking for Account Resolution Specialists to join our Agency Collections team in Columbus/Dublin, Ohio. Our Account Resolution...
  • 15 Days Ago

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Nurse Practitioner
  • Ankle and Foot Specialist Marion Inc
  • Marion, OH FULL_TIME
  • Ankle and Foot Specialists of Marion is seeking a NP to add to our growing practice! This provider will participate in all aspects of patient care as indicated and perform the duties described below. ...
  • 1 Month Ago

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Postdoctoral Fellow in High Resolution Retinal Imaging
  • The Ohio State University
  • Columbus, OH FULL_TIME,CONTRACTOR
  • A NIH funded Post Doctoral Scholar position is available in the laboratory of Dr. Nathan Doble in the College of Optometry/Department of Ophthalmology and Visual Science at The Ohio State University (...
  • 13 Days Ago

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Specialist
  • Maryhaven, Inc
  • Columbus, OH FULL_TIME
  • Crisis Specialist Job Description Unique opportunity to join Maryhaven, Central Ohio’s largest and most comprehensive behavioral services provider specializing in addiction recovery. We remain driven ...
  • Just Posted

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Specialist
  • FST Logistics
  • Grove, OH FULL_TIME
  • Responsibilities : The OS&D Operations Specialist is responsible for completing administrative tasks regarding Over, Short, and Damaged freight both internally and externally. complete all aspects reg...
  • Just Posted

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0 Appeal Resolution Specialist jobs found in Columbus, OH area

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Customer Support Specialist - Work From Home>
  • Zip
  • Columbus, OH
  • [Customer Service / Fully Remote] - Anywhere in U.S. / Up to $75K per year / Full health, vision & dental / Apple equipm...
  • 3/29/2024 12:00:00 AM

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Customer Support Specialist - Work From Home>
  • Zip
  • Hilliard, OH
  • [Customer Service / Fully Remote] - Anywhere in U.S. / Up to $75K per year / Full health, vision & dental / Apple equipm...
  • 3/29/2024 12:00:00 AM

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Customer Support Specialist - Work From Home>
  • Zip
  • Galloway, OH
  • [Customer Service / Fully Remote] - Anywhere in U.S. / Up to $75K per year / Full health, vision & dental / Apple equipm...
  • 3/29/2024 12:00:00 AM

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Sleep Expert - Sales
  • Mattress Firm
  • Columbus, OH
  • Is your current job a nightmare? Make it a dream job at Mattress Firm®! Join Mattress Firm as a Sleep Expert® and have t...
  • 3/27/2024 12:00:00 AM

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Regional Customer Support Senior Expert *
  • SMA Solar Technology AG
  • Dublin, OH
  • Deine Rolle: Regional Customer Support Senior Expert * Am Standort: Kassel, DE **"Der Wandel der Energiewirtschaft brauc...
  • 3/27/2024 12:00:00 AM

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Smashburger - Westerville - Guest Service Expert
  • Smashburger - Westerville
  • Westerville, OH
  • EOE. We participate in E-Verify / Participamos en E-Verify Our first Smashburger restaurant opened in 2007 with one sing...
  • 3/25/2024 12:00:00 AM

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Manufacturing Technical Expert (Stamping)
  • American Honda Motor Co Inc
  • Marysville, OH
  • At Honda, The Power of Dreams drives us to create intelligent products that enhance mobility and increase the joy in peo...
  • 3/25/2024 12:00:00 AM

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Sleep Expert - Sales
  • Mattress Firm
  • Lancaster, OH
  • Is your current job a nightmare? Make it a dream job at Mattress Firm®! Join Mattress Firm as a Sleep Expert® and have t...
  • 3/16/2024 12:00:00 AM

The confluence of the Scioto and Olentangy rivers occurs just north-west of Downtown Columbus. Several smaller tributaries course through the Columbus metropolitan area, including Alum Creek, Big Walnut Creek, and Darby Creek. Columbus is considered to have relatively flat topography thanks to a large glacier that covered most of Ohio during the Wisconsin Ice Age. However, there are sizable differences in elevation through the area, with the high point of Franklin County being 1,132 ft (345 m) above sea level near New Albany, and the low point being 670 ft (200 m) where the Scioto River leaves...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Specialist jobs
$46,634 to $57,769
Columbus, Ohio area prices
were up 1.3% 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