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)
Cites the key essentials in maintaining a good document management system.
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Level 2 Behaviors
(Light Experience)
Assists in filing, printing, and scanning electronic records to support document management.
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Level 3 Behaviors
(Moderate Experience)
Executes record retention policies in managing and organizing documents on the file management system.
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Level 4 Behaviors
(Extensive Experience)
Directs document management processes by guiding document storage for easy access to information.
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Level 5 Behaviors
(Mastery)
Articulates technology into document management initiatives to ensure information is well organized and shared.
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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)
Cites examples of best practices for contract compliance management.
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Level 2 Behaviors
(Light Experience)
Assists in reviewing business contracts to ensure compliance with established corporate guidelines.
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Level 3 Behaviors
(Moderate Experience)
Analyzes new contracts to ensure compliance with requirements, standards, and business interests.
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Level 4 Behaviors
(Extensive Experience)
Develops established policies and procedures to ensure compliance with laws and contracts.
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Level 5 Behaviors
(Mastery)
Builds systems for monitoring contract services to ensure compliance with policies and procedures.
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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)
Cites examples of SOP practices in our business operations.
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Level 2 Behaviors
(Light Experience)
Assists in the preparation of internal standard operating procedures (SOP).
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Level 3 Behaviors
(Moderate Experience)
Analyses our business and operations to identify room for improvement on the related standard operating procedures.
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Level 4 Behaviors
(Extensive Experience)
Coaches others on the implementation of SOP to reduce errors and improve quality.
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Level 5 Behaviors
(Mastery)
Builds a monitoring system to evaluate the effectiveness of our 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)
Cites steps and tips to improve attention to detail in the workplace.
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Level 2 Behaviors
(Light Experience)
Keeps full attention when listening to understand the message.
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Level 3 Behaviors
(Moderate Experience)
Balances between accuracy and efficiency for different tasks or programs.
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Level 4 Behaviors
(Extensive Experience)
Creates and implements quality management processes for our business.
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Level 5 Behaviors
(Mastery)
Defines possible hurdles to projects and creates strategies to deal with them.
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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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