Appeal Resolution Supervisor jobs in Los Angeles, CA

Appeal Resolution Supervisor supervises a team responsible for the processing of appeals. Assigns and prioritizes cases. Being an Appeal Resolution Supervisor responds to and resolves escalated issues. Coaches and trains team in the utilization of industry standards and best practices. Additionally, Appeal Resolution Supervisor requires a bachelor's degree. Typically reports to a manager. The Appeal Resolution Supervisor supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes and procedures. To be an Appeal Resolution Supervisor typically requires 3 years experience in the related area as an individual contributor. Thorough knowledge of functional area under supervision. (Copyright 2024 Salary.com)

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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 correspondence
     
    3.Provide reports and on-going updates to Claims management.
     
    4.Assist in the processing of appeals (reconsiderations), special projects and reconciliations from all sources.
     
    5.Oversees staff activities to maintain high level of productivity.
     
    6.Monitor appeals related functions to ensure health plan and regulatory compliance.
     
    7.Participate with training determined by Unit Senior Manager and Auditing Staff regarding Claims Adjudication education issues discovered in reconsideration reviews.
     
    8.Provide primary support to the Senior Manager of Appeals including special projects.
     
    9.Recommend process improvements based on appeal tracking and trending reports.
     
    10.Support Senior Manager in other company functions such as Medical Review management Health Plan audits.
     
    11.Handle and document resolution to escalated telephone and written appeals.
     
    12.Implement and coordinate issue resolution processes.
     
    13.Liaison for department with outside providers and internal departments.
     
    14.Provide supervisory coverage for Appeals unit as needed.
     
    15.Other duties as directed by management.
     

    The pay range for this position at commencement of employment is expected to be between $22.50-24.50/hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.

     

    The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.

     

    Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

     

    If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

     

     

    As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

     

    Full Time Position Benefits:

    The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.

    Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.

     

    Health and Wellness:

    • Employer-paid comprehensive medical, pharmacy, and dental for employees
    • Vision insurance
    • Zero co-payments for employed physician office visits
    • Flexible Spending Account (FSA)
    • Employer-Paid Life Insurance
    • Employee Assistance Program (EAP)
    • Behavioral Health Services

    Savings and Retirement:

    • 401k Retirement Savings Plan
    • Income Protection Insurance

    Other Benefits:

    • Vacation Time
    • Company celebrations
    • Employee Assistance Program
    • Employee Referral Bonus
    • Tuition Reimbursement
    • License Renewal CEU Cost Reimbursement Program
    • Business-casual working environment
    • Sick days
    • Paid holidays
    • Mileage

     

    Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

     

     

  • 1 Month Ago

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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

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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...
  • 9 Days Ago

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Office Administrator (Resolution Dept.)
  • Anderson Bradshaw Consulting
  • Los Angeles, CA FULL_TIME
  • Job Overview:As a Resolution Department Office Administrator, you will play a crucial role in ensuring the smooth operation of our resolution teams office environment. Your responsibilities will inclu...
  • Just Posted

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Provider Dispute Resolution Analyst
  • UCLA Health Careers
  • Los Angeles, CA FULL_TIME
  • DescriptionTake on a key role within a world-class, award-winning health system. Elevate the operational effectiveness of an award-winning healthcare leader. Take your career in an exciting new direct...
  • 5 Days Ago

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Credit Resolution Assistant Manager
  • Water and Power Community Credit Union
  • Los Angeles, CA OTHER
  • Job Details Job Location: Sunset - Los Angeles, CA Position Type: Full Time Salary Range: $79,190.18 - $118,785.26 Salary Job Shift: Day Job Category: Finance DescriptionRole: To provide value added m...
  • 1 Month Ago

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

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Desktop Support Engineer
  • Brown & Brown Insurance
  • Irvine, CA
  • Brown & Brown is looking for a Field Service Engineer/Desktop Engineer to join our growing team As a member of the Brown...
  • 4/25/2024 12:00:00 AM

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Project Engineer
  • Clark Pacific
  • Ontario, CA
  • At Clark Pacific, exciting building projects are just the beginning! As the West Coast’s leading prefabricator of buildi...
  • 4/25/2024 12:00:00 AM

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Import Manager
  • Talmo & Associates
  • Los Angeles, CA
  • We are hiring an Import Manager to lead the Customs Brokerage Department. Location: Monterey Park, CA Role: Import Manag...
  • 4/24/2024 12:00:00 AM

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CA: Senior Associate Counsel ($2500 signing bonus)
  • Green Dot Public Schools California
  • Los Angeles, CA
  • Thank you for your interest. If you are a Green Dot employee, please apply using the Career Worklet on the Workday Home ...
  • 4/24/2024 12:00:00 AM

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Litigation Paralegal
  • AGG Legal Staffing
  • Los Angeles, CA
  • Litigation Paralegal will assist attorneys with various substantive and administrative responsibilities from case incept...
  • 4/23/2024 12:00:00 AM

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Loan Resolution Coordinator
  • AMIP Management
  • Anaheim, CA
  • Position: Loan Resolution Coordinator Status: Full-Time / Non-Exempt The Company: American Mortgage Investment Partners ...
  • 4/23/2024 12:00:00 AM

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Transportation Customer Service
  • SFI Los Angeles
  • Carson, CA
  • Job Description Job Description Our global 3rd Party Logistics company is currently seeking a Customer Service Represent...
  • 4/23/2024 12:00:00 AM

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Loan Resolution Coordinator
  • Amip Management
  • Anaheim, CA
  • Position: Loan Resolution Coordinator Status: Full-Time / Non-Exempt The Company: American Mortgage Investment Partners ...
  • 4/23/2024 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 Supervisor jobs
$76,969 to $94,107
Los Angeles, California area prices
were up 3.2% from a year ago