Appeal Resolution Supervisor jobs in Tallahassee, FL

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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Resolution specialist
  • Acentra Health
  • Tallahassee, FL FULL_TIME
  • CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise.

    Our mission is to innovate health solutions that deliver maximum value and impact.

    Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company;

    to actively engage in problem solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities.

    In fact, you have all you need to take charge of your career and accelerate better outcomes making this a great time to join our team of passionate individuals dedicated to being a vital partner for health

    Acentra Health is currently looking for Adjustment & Resolution Representative with experience in Claims / Billings to join our Tallahassee team!

    The Adjustment & Resolutions Representative will assist with bill-specific research to resolve outstanding issues for a Federal Worker’s Compensation Program.

    You will also participate in guidance on this program and assist with departmental inventory management, identifying trends, and work assignments for staff.

    You will have an opportunity to become diverse in a variety of claim types as you grow with our team!

    Candidate Must be able to work out of the Tallahassee, FL office facility.

    This is a Federal Contract : you will be required to pass a federal background check and fingerprinting before you can start

    Responsibilities :

    • Review submitted bills requesting adjustment consideration, and research as needed to determine outcome
    • Research and Resolve medical bill data, making necessary corrections of information by comparing data with source documents to identify root causes
    • Request additional information as needed to complete the adjudication of bills.
    • Make appropriate bill adjustment into the claims system according to contractual requirements and timelines
    • Process bills according to Government policies and procedures.
    • You will possess an unwavering commitment to customer service and operational excellence

    Required Qualifications / Experience

    • High school diploma or GED with at least five (5) years experience conducting research to resolve issues within the healthcare field
    • Expert knowledge of medical terminology including medical diagnosis and procedure codes
    • Familiarity with medical bill / claim forms, ICD-9 / 10CM coding, CPT coding, bill forms, and other medical coding schemes (certificate desired).
    • Ability to simultaneously maneuver through various computer claims and eligibility platforms
    • General knowledge of Workers Compensation and medical terminology
    • Outstanding customer satisfaction skills

    Why us?

    We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry.

    State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

    We do this through our people.

    You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

    Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work.

    Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

    Benefits

    Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work.

    Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

    Compensation

    Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.

    Thank You!

    We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted.

    We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest.

    Best of luck in your search!

    The Acentra Health Talent Acquisition Team

    EOE AA M / F / Vet / Disability

    Acentra Health 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, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

    Requirements

    Required Qualifications / Experience

    • High school diploma or GED with at least five (5) years experience conducting research to resolve issues within the healthcare field
    • Expert knowledge of medical terminology including medical diagnosis and procedure codes
    • Familiarity with medical bill / claim forms, ICD-9 / 10CM coding, CPT coding, bill forms, and other medical coding schemes (certificate desired).
    • Ability to simultaneously maneuver through various computer claims and eligibility platforms
    • Last updated : 2024-02-26

  • 28 Days Ago

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Account Resolution Specialist
  • United Solutions Company
  • Tallahassee, FL FULL_TIME
  • JOB TITLE: ACCOUNT RESOLUTION SPECIALIST JOB TYPE: Full-timeSALARY: Starting rate of $16.00 per hour. May vary based on experience.BENEFITS:Health InsuranceLife InsuranceAccidental Death & Dismemberme...
  • 3 Days Ago

A
Resolution and Adjustment Specialist
  • Acentra Health
  • Tallahassee, FL FULL_TIME
  • CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that de...
  • 1 Month Ago

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Problem Resolution Associate - In Office (Tallahassee, FL)
  • Alight Solutions
  • Tallahassee, FL FULL_TIME
  • Our storyAt Alight, we believe a company's success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to "Be Al...
  • 12 Days Ago

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Restaurant supervisor
  • Legends
  • Tallahassee, FL FULL_TIME
  • Directly manage staff while having direct interaction with customers; Maintain and control high volume food and beverage inventory; Train, educate, and enforce responsible service of alcoholic beverag...
  • 18 Days Ago

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Fleet supervisor
  • Penske
  • Quincy, FL FULL_TIME
  • Responsibilities As a Penske Maintenance Supervisor you will use your excellent communication, organization, and multitasking skills to engage your diesel technicians, maintain good morale among your ...
  • 18 Days Ago

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0 Appeal Resolution Supervisor jobs found in Tallahassee, FL area

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Benefits Administrator
  • Leon County BOCC
  • Tallahassee, FL
  • Salary: $57,712.00 - $95,224.00 Annually Location: Leon County Government Annex - 315 S. Calhoun St. Tallahassee, FL Job...
  • 3/28/2024 12:00:00 AM

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House Drafter (Bill Drafting Service)
  • State of Florida
  • Tallahassee, FL
  • Do not click the Apply button. Applications are available Here. The Florida Legislature The Florida House of Representat...
  • 3/28/2024 12:00:00 AM

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Internal Revenue Agent - 12 Month Roster
  • Department Of The Treasury
  • Tallahassee, FL
  • Duties WHAT IS THE LARGE BUSINESS AND INTERNATIONAL(LB&I)DIVISION? A description of the business units can be found at: ...
  • 3/28/2024 12:00:00 AM

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State Freight And Rail Manager -55006604
  • Florida Department of Transportation
  • Tallahassee, FL
  • Requisition No: 819834 Agency: Department of Transportation Working Title: STATE FREIGHT AND RAIL MANAGER -55006604 Pay ...
  • 3/28/2024 12:00:00 AM

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Internal Revenue Agent (Fed State Local Gvmt Spec - Examiner) 12 MONTH ROSTER AMENDED
  • Department Of The Treasury
  • Tallahassee, FL
  • Duties WHAT IS THE TAX EXEMPT & GOVERNMENT ENTITIES (TE/GE) DIVISION? A description of the business units can be found a...
  • 3/27/2024 12:00:00 AM

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Internal Revenue Agent/ Senior Revenue Agent (Examiner)- (12 Month Roster)- Amended
  • Department Of The Treasury
  • Tallahassee, FL
  • Duties WHAT IS THE LARGE BUSINESS AND INTERNATIONAL (LBI) DIVISION? A description of the business units can be found at:...
  • 3/27/2024 12:00:00 AM

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Internal Revenue Agent/ Senior Revenue Agent (Examiner)- (6 Month Roster) - Amended
  • Department Of The Treasury
  • Tallahassee, FL
  • Duties WHAT IS THE LARGE BUSINESS AND INTERNATIONAL (LBI) DIVISION? A description of the business units can be found at:...
  • 3/27/2024 12:00:00 AM

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Library Services Coordinator - Jane G Sauls Ft Braden Branch Library
  • Leon County BOCC
  • Tallahassee, FL
  • Salary: $52,346.16 - $86,371.16 Annually Location: Jane G. Sauls Fort Braden Branch Library - 16327 Blountstown Hwy. Tal...
  • 3/26/2024 12:00:00 AM

Tallahassee (/ˌtæləˈhæsi/) is the capital city of the U.S. state of Florida. It is the county seat and only incorporated municipality in Leon County. Tallahassee became the capital of Florida, then the Florida Territory, in 1824. In 2017, the population was 191,049, making it the 7th-largest city in the U.S state of Florida, and the 126th-largest city in the United States. The population of the Tallahassee metropolitan area was 382,627 as of 2017[update]. Tallahassee is the largest city in the Florida Panhandle region, and the main center for trade and agriculture in the Florida Big Bend and S...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Appeal Resolution Supervisor jobs
$62,098 to $75,928
Tallahassee, Florida area prices
were up 1.5% from a year ago