Appeal Resolution Specialist jobs in Los Angeles, CA

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)

U
Case Resolution Specialist, ELR
  • University of Southern California
  • Los Angeles, CA FULL_TIME
  • Case Resolution Specialist, ELR Human Resources Los Angeles, California

    The Case Resolution Specialist, Employee & Labor Relations (ELR) provides impartial consultation, conflict resolution, and problem solving in response to workplace complaints from various campus stakeholders. Conducts inquiries, analysis, and case resolution, and assists in the development and maintenance of relevant policies, procedures, and guidelines. Responsible for maintaining accurate, up-to-date records and documentation. Stays current with modern case resolution methods and best practices to proactively resolve workplace concerns.

    Minimum Qualifications

    The candidate for the position of Case Resolution Specialist, ELR must meet the following qualifications:

    • Bachelor's degree from an accredited institution in a related field, or combined experience/education as substitute for minimum education.

    • Five years' experience. Four or more years of relevant work experience resolving workplace disputes, engaging in conflict resolution in a large, multi-faceted organization, conducting workplace investigations, and/or any equivalent combination of education and experience.

    • Ability to gather, organize, and synthesize information, conduct analysis, document progress, and make effective recommendations for complex and sensitive issues.

    • Ability to adhere and enforce complaint procedures and fundamental components of fair process standards.

    • Knowledge of best practices used to investigate and resolve employee concerns or grievances, including best practices as they relate to reducing bias during resolution processes.

    • Proven skill, sensitivity and experience interacting with diverse groups of constituents (e.g., regarding age, race, gender identity/expression, ability, socioeconomic background) in a culturally sensitive manner.

    • Excellent written and oral communication skills, able to interact with varied audiences and levels of leadership to inspire further action.

    • Demonstrated experience with complex workplace investigations and writing comprehensive investigative reports.

    • Ability to present complex issues in a clear and concise manner.

    • Excellent customer service skills.

    Preferred Qualifications

    The ideal candidate for the position of Case Resolution Specialist, ELR has the following qualifications:

    • Master's degree in human resources, psychology, communications, law, industrial relations or another related field, or Juris Doctorate degree.

    • Experience with case management software/databases.

    • Knowledge and/or understanding of numerous relevant cultural issues (e.g., immigration, socioeconomic, LGBTQIA ).

    • Multilingual communication skills, fluent in Spanish and/or other languages beyond English.

    • Experience in, and awareness of, the sensitivity required when interacting with diverse communities on trauma-related topics.

    • Certification in workplace investigations or similar subject matters.

    • Conflict resolution, alternative dispute resolution, or conflict management skills.

    • Excellent presentation, data visualization, and facilitation skills with an emphasis on education/training for varied constituencies.

    Job Responsibilities

    The candidate for the position of Case Resolution Specialist, ELR will be responsible for:

    • Developing and communicating results, corrective actions, and recommendations for appropriate resolutions to an array of complex workplace issues using a variety of tools (e.g., facilitated dialogue, shuttle diplomacy, other alternative dispute resolution methods). Drafts, implements, and monitors informal resolution agreements.

    • Conducting impartial, confidential, trauma-informed interviews and fact-gathering meetings to investigate workplace complaints and inquiries. Interviews employees, collects appropriate documentation, reviews information from a variety of sources, and provides support as the case is facilitated to resolution. Ensures a well-documented, prompt, and equitable process for all parties.

    • Documenting and maintaining employee relations and workplace concerns and individual case updates in a case management system in a timely manner. Ensures all employee and labor relations and workplace concerns are addressed.

    • Providing outreach and training on matters related to resolving workplace concerns according to university policies, procedures, and processes to various audiences. May work in collaboration with other unit members to perform projects and conduct background research to assist with cases, training, and development of outreach and other programming materials.

    • Assisting with writing and maintaining employee policies and procedures, ensuring compliance with university policies and procedures. Works to foster and maintain effective, collegial relationships with internal/external stakeholders in support of university goals and values. Stays current with modern case resolution methods and best practices to proactively resolve workplace concerns. Promotes an environment that fosters inclusive relationships and creates unbiased opportunities for contributions through ideas, words, and actions that uphold principles of the USC Code of Ethics.

    • Performing other related responsibilities as requested and when necessary. The university reserves the right to add or change duties at any time.

    Please submit the following with your application:

    • Resume

    • Writing Sample such as a deidentified closure notice from past or response to current prompt.
      Sample should be 1-2 pages, no more than 1200 words, 12 pt font; can be fictitious.

    The annual base salary range for this position is $98,047.19 - $106,624.00. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

    The University of Southern California is an Equal Opportunity Employer


    Minimum Education: Bachelor's degree Minimum Experience: 5 years 4 years of relevant work experience resolving workplace disputes, engaging in conflict resolution in a large, multi-faceted organization, conducting workplace investigations, and/or any equivalent combination of education and experience. Minimum Skills: Bachelor's Degree from an accredited institution in a related field. Ability to gather, organize, and synthesize information, conduct analysis, document progress, and make recommendations for complex and sensitive issues. Ability to adhere and enforce complaint procedures and fundamental components of fair process standards. Knowledge of best practices used to investigate and resolve employee concerns or grievances including best practices as they relate to reducing bias during grievance resolution processes. Proven skill, sensitivity and experience interacting with constituents who are diverse in characteristics such as age, education level, race, gender identity and expression, ability, and socioeconomic backgrounds in a culturally sensitive manner. Demonstrated written and oral communication skills; skill-building rapport in an open, friendly, and accepting way. Ability to present complex issues in a clear, concise, and visually appealing manner. Ability to communicate in writing and verbally for variety of audiences and levels of leadership to inspire further action. Excellent customer service skills.


    REQ20141361 Posted Date: 02/20/2024
    USC is an equal opportunity, affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other characteristic protected by law or USC policy. USC will consider for employment all qualified applicants with criminal histories in a manner consistent with the requirements of the Los Angeles Fair Chance Initiative for Hiring ordinance.

     

  • 24 Days Ago

P
Account Resolution Specialist
  • Prime Healthcare Services
  • Lynwood, CA FULL_TIME
  • Location US-CA-Lynwood ID 2024-155183 Category Business Professional Position Type Full Time Shift Days Job Type Non-Exempt OverviewPrime Healthcare is an award-winning health system headquartered in ...
  • 1 Month Ago

Q
Claims Appeal Auditor
  • QUALITY CARE SURGERY CENTER, LLC
  • Northridge, CA FULL_TIME
  • Essential Duties and Responsibilities include the following: 1.Maintain the workflow of all departmental projects. 2.Ensure priority sorting, batching & logging by provider and provider type for all c...
  • 1 Month Ago

R
Los Angeles, CA: Consultant
  • Resolution Economics
  • Los Angeles, CA FULL_TIME
  • Title Los Angeles, CA: Consultant Position Illinois: Consultant Location Century City Req Number CON-24-00009 Description Company Description: Resolution Economics is a leading economic consulting fir...
  • 1 Month Ago

P
Underpayment Analyst, Claims Appeal Representative
  • Providence
  • Burbank, CA OTHER
  • DescriptionProvidence St. Joseph Health is calling an Underpayments Claims Appeal Representative to work remotely within our footprint states: AK, CA, MT, OR, TX and/or WA.The Underpayments Claims App...
  • 6 Days Ago

I
ERP Business Analyst - IT Systems Specialist
  • IT Systems Specialist - Knowhirematch
  • Los Angeles, CA FULL_TIME
  • Title: ERP Business Analyst - IT Systems SpecialistCompany Overview:Join an innovative IT organization committed to enhancing business applications and driving process improvements. Our team specializ...
  • 18 Days Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

0 Appeal Resolution Specialist jobs found in Los Angeles, CA area

S
Open Platform Expert
  • SHOPLINE
  • Los Angeles, CA
  • About SHOPLINE: SHOPLINE is Asia's largest smart commerce platform, dedicated to providing scalable business solutions t...
  • 4/22/2024 12:00:00 AM

S
Open Platform Expert
  • Shopline
  • Los Angeles, CA
  • About SHOPLINE: SHOPLINE is Asia's largest smart commerce platform, dedicated to providing scalable business solutions t...
  • 4/22/2024 12:00:00 AM

A
Boeing Avionx Integration and Test Engineer (Senior or Subject Matter Expert)
  • ARGON ST
  • Long Beach, CA
  • Job Description At Boeing, we innovate and collaborate to make the world a better place. From the seabed to outer space,...
  • 4/21/2024 12:00:00 AM

F
Fiverr Expert
  • Fud Inc.
  • Los Angeles, CA
  • Fud is on a mission to empower people to earn a living on their own terms. As the world's first social hustling communit...
  • 4/21/2024 12:00:00 AM

C
Subject Matter Expert (SME) for Health Administration (Remote/Hybrid) - (Contractor)
  • Confidential
  • Los Angeles, CA
  • Job Summary: We are actively searching for a Subject Matter Expert (SME) with a comprehensive background in health admin...
  • 4/20/2024 12:00:00 AM

C
Subject Matter Expert (SME) for Health Administration (Remote/Hybrid) - (Contractor)
  • Confidential
  • Irvine, CA
  • Job Summary: We are actively searching for a Subject Matter Expert (SME) with a comprehensive background in health admin...
  • 4/20/2024 12:00:00 AM

F
Fiverr Expert
  • Fud, Inc.
  • Los Angeles, CA
  • Fud is on a mission to empower people to earn a living on their own terms. As the world's first social hustling communit...
  • 4/18/2024 12:00:00 AM

2
Sales and Service Expert
  • 24 Hour Fitness, INC.
  • Costa Mesa, CA
  • **FULL-TIME** Part-time **LOCATION** 589 Anton Avenue Costa Mesa CA 92626 **Sales and Service Expert** **?** **Who we?ar...
  • 4/18/2024 12:00:00 AM

Los Angeles (/lɔːs ˈændʒələs/ (listen);[a] Spanish: Los Ángeles), officially the City of Los Angeles and often known by its initials L.A., is the most populous city in California, the second most populous city in the United States, after New York City, and the third most populous city in North America. With an estimated population of four million, Los Angeles is the cultural, financial, and commercial center of Southern California. The city is known for its Mediterranean climate, ethnic diversity, Hollywood and the entertainment industry, and its sprawling metropolis. Los Angeles is the larges...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Specialist jobs
$53,104 to $65,786
Los Angeles, California area prices
were up 3.2% 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