Skills & Competencies for Appeal Resolution Specialist

Appeal Resolution Specialist job profile

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JOB SUMMARY for Appeal Resolution Specialist

Logs, tracks, and processes appeals and grievances.

JOB RESPONSIBILITIES for Appeal Resolution Specialist

Sets up and maintains case files for each grievance and collects the information required by organizational policies and applicable regulations. Conducts research and coordination needed to evaluate, process, respond to, and refer or close appeals.

Appeal Resolution Specialist SALARY RANGE

BASE 50%
$52,689
TOTAL 50%
$53,820
Job Level
A02
Job Code
HC07000516
Education/Degree
Associate's Degree
Reports To
Supervisor

Appeal Resolution Specialist Skills and Competencies List

Proficiency Levels and Behavioural Indicators
Salary.com identifies five increasing levels of proficiency for each skill/competency. Some jobs require only a relatively low level of proficiency in each skill/competency, while other jobs will require a more advanced level of proficiency in the same skill/competency. These levels rate the degree of proficiency (skill level, expertise) we expect the incumbent to perform in the given skill/competency for the given job. Note that we intentionally do not associate timeframes or years of experience in performing the skill/competency because that can be misleading. Proficiency levels identify what the incumbent knows and can do rather than how long they have been doing it. Also, note that the proficiency levels are cumulative, e.g., a level 4 proficiency implies the ability to perform all the behaviors at the lower levels.
Check each Appeal Resolution Specialist skill and competencie below to view definitions.
JOB FAMILY COMPETENCIES CORE COMPETENCIES
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7 general skills or competencies (Job family competencies) for Appeal Resolution Specialist

1 Job Family Competencies – Document Management
Proficiency Level -2
Skill definition-Capturing, tracking, storing, and retrieving digital information to organize files, improve accuracy, and provide easy access to documents.
Level 1 Behaviors
(General Familiarity)
Explains the procedures and best practices related to document management functions.
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Level 2 Behaviors
(Light Experience)
Supports implementation of process changes on document management to ensure smooth file organization.
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Level 3 Behaviors
(Moderate Experience)
Reviews and finalizes all document change requests by the appropriate department on time.
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Level 4 Behaviors
(Extensive Experience)
Provides effective document management following relevant policies and procedures.
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Level 5 Behaviors
(Mastery)
Leads the development of a document lifecycle to ensure compliance and reduce errors.
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2 Job Family Competencies – Contract Compliance
Proficiency Level -2
Skill definition-Ability to comply with regulations and performance of obligations within the agreement.
Level 1 Behaviors
(General Familiarity)
Explains the importance of understanding agreement terms and conditions in contract compliance.
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Level 2 Behaviors
(Light Experience)
Reports issues to management during the monitoring of contract compliance.
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Level 3 Behaviors
(Moderate Experience)
Participates in defining the terms of contract agreements to ensure compliance.
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Level 4 Behaviors
(Extensive Experience)
Monitors contract compliance to determine the necessity for amendments or extensions of contracts.
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Level 5 Behaviors
(Mastery)
Establishes policies and procedures to ensure compliance with contract agreements.
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3 Appeal Resolution Specialist - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Appeal Resolution Specialist
Proficiency Level - 4
5 Competency for - Appeal Resolution Specialist
Proficiency Level - 5

7 soft skills or competencies (core competencies) for Appeal Resolution Specialist

1 Core Competencies – Standard Operating Procedures (SOP)
Proficiency Level -2
Skill definition-A set of written instructions that describes the step-by-step activities to complete tasks in compliance with business standards and industry regulations.
Level 1 Behaviors
(General Familiarity)
Identifies our internal and external sources for the SOPs we need.
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Level 2 Behaviors
(Light Experience)
Participates in the implementation of new SOPs and enhancement of existing ones.
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Level 3 Behaviors
(Moderate Experience)
Modifies SOPs accordingly to reflect changes in our business practices and policies.
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Level 4 Behaviors
(Extensive Experience)
Optimizes the current SOP development and implementation processes.
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Level 5 Behaviors
(Mastery)
Leads cross-functional efforts to develop and implement SOPs across our organization.
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2 Core Competencies – Attention to Detail
Proficiency Level -2
Skill definition-Executing and completing a task with a high level of accuracy.
Level 1 Behaviors
(General Familiarity)
Lists best practices and tools to maintain high accuracy and thoroughness in the workplace.
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Level 2 Behaviors
(Light Experience)
Uses checklists to ensure that information goes out error-free.
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Level 3 Behaviors
(Moderate Experience)
Suggests solutions to issues that arise while executing the tasks.
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Level 4 Behaviors
(Extensive Experience)
Employs techniques for motivating personnel to meet or exceed accuracy goals.
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Level 5 Behaviors
(Mastery)
Leads the creation of tools for enhancing and assuring accuracy.
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3 Appeal Resolution Specialist - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Appeal Resolution Specialist
Proficiency Level - 4
5 Competency for - Appeal Resolution Specialist
Proficiency Level - 5

Summary of Appeal Resolution Specialist skills and competencies

There are 0 hard skills for Appeal Resolution Specialist.
7 general skills for Appeal Resolution Specialist, Document Management, Contract Compliance, Contract Review, etc.
7 soft skills for Appeal Resolution Specialist, Standard Operating Procedures (SOP), Attention to Detail, Time Management, etc.
While the list totals 14 distinct skills, it's important to note that not all are required to be mastered to the same degree. Some skills may only need a basic understanding, whereas others demand a higher level of expertise.
For instance, as a Appeal Resolution Specialist, he or she needs to be proficient in Standard Operating Procedures (SOP), be proficient in Attention to Detail, and be proficient in Time Management.

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