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%
$51,543
TOTAL 50%
$52,649
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 principles and procedures of document management systems.
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Level 2 Behaviors
(Light Experience)
Conducts basic document management tasks in your organization's computer systems.
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Level 3 Behaviors
(Moderate Experience)
Prepares electronic documents in adherence to formats and structures to ensure an organized document system.
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Level 4 Behaviors
(Extensive Experience)
Oversees the overall process of document handling according to document management policies.
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Level 5 Behaviors
(Mastery)
Establishes organizational structure for document management to achieve deliverables.
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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)
Documents the contract terms and conditions required for proper compliance.
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Level 2 Behaviors
(Light Experience)
Conducts contract audits to aid the management in determining the source of non-compliance issues.
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Level 3 Behaviors
(Moderate Experience)
Coordinates contract and subcontract requirements with all departments to ensure compliance.
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Level 4 Behaviors
(Extensive Experience)
Manages contractual obligations to ensure compliance with agreed terms and conditions.
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Level 5 Behaviors
(Mastery)
Designs and develops various compliance contracts throughout your organization.
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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)
Discusses the considerations and concerns on applying SOP for the first time.
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Level 2 Behaviors
(Light Experience)
Gathers information on workflows and business controlling points.
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Level 3 Behaviors
(Moderate Experience)
Maintains the accuracy of SOPs to provide consistent guidance in our workplace.
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Level 4 Behaviors
(Extensive Experience)
Leverages the use of SOPs to solve business and operation problems.
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Level 5 Behaviors
(Mastery)
Keeps abreast of industry regulation and its effect on our internal SOPs.
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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)
Identifies the procedures for making sure that results are mistake-free.
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Level 2 Behaviors
(Light Experience)
Records all appointments on the calendar to easily track daily activities.
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Level 3 Behaviors
(Moderate Experience)
Sets up processes to ensure delivery of high-quality work.
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Level 4 Behaviors
(Extensive Experience)
Designs systems to help the team organize and track details and project progress.
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Level 5 Behaviors
(Mastery)
Develops best practices for identifying and correcting errors, oversights, and omissions.
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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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