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%
$51,672
TOTAL 50%
$52,778
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)
Lists commonly used software in document management for accurate record tracking and storage.
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Level 2 Behaviors
(Light Experience)
Supports the configuration of document management systems for a centralized repository.
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Level 3 Behaviors
(Moderate Experience)
Uses the document management system database to maximize document storage and review functions.
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Level 4 Behaviors
(Extensive Experience)
Recommends solutions to resolve document risks to prevent document losses and misfiling.
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Level 5 Behaviors
(Mastery)
Mentors relevant teams responsible for electronic and physical documents to drive efficiency in document management.
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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)
Lists all the procedures used in verifying compliance with contract requirements.
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Level 2 Behaviors
(Light Experience)
Supports the development of contract compliance within your organization.
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Level 3 Behaviors
(Moderate Experience)
Reviews important contract language to identify financial and legal impacts.
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Level 4 Behaviors
(Extensive Experience)
Oversees the contract negotiations between both parties to ensure safety and regulatory compliance.
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Level 5 Behaviors
(Mastery)
Keeps up to date with all compliance policies to ensure alignment 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)
Lists the typical processes of SOP development.
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Level 2 Behaviors
(Light Experience)
Supports the analysis of our business and operations processes for SOP design and development.
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Level 3 Behaviors
(Moderate Experience)
Researches new tools and techniques for SOP daily management.
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Level 4 Behaviors
(Extensive Experience)
Resolves complex issues arising from SOP practices; develops preventative solutions accordingly.
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Level 5 Behaviors
(Mastery)
Monitors industry for SOP trends and best practices; makes recommendations about those that benefit our business.
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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)
Explains why attention to detail plays an important role in own function or unit.
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Level 2 Behaviors
(Light Experience)
Performs assigned responsibilities according to standard procedures and standards.
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Level 3 Behaviors
(Moderate Experience)
Implements a variety of cross-checking approaches and mechanisms.
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Level 4 Behaviors
(Extensive Experience)
Demonstrates expertise in quality assurance tools, techniques, and standards.
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Level 5 Behaviors
(Mastery)
Designs techniques for measuring the cost and impact of errors.
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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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