Appeal Resolution Manager jobs in the United States

Appeal Resolution Manager manages the grievance process to review, investigate, document, process, negotiate, and resolve disputed medical, insurance, and other claims. Oversees work activity that is compliant with all regulatory guidelines and policy protocols. Being an Appeal Resolution Manager allocates team resources to ensure an effective and balanced case workload. Applies industry standards and uses best practices in the preparation of legal briefs. Additionally, Appeal Resolution Manager may represent the organization at hearings. Requires a bachelor's degree. Typically reports to a senior manager or head of a unit/department. The Appeal Resolution Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be an Appeal Resolution Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2022 Salary.com)

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Utilization Manager-Duke Raleigh
  • Duke Health
  • Bynum, NC
  • Manage concurrent cases to resolution care that may impact payer approval to authorize care as ... or appeals as necessary in accordance with the UM plan. * Facilitates mitigation of denials and ...
  • yesterday

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Provider Relations Representative
  • ApolloMed
  • Remote, OR
  • ... Complaints and appeals - Policies and procedures - Identify opportunities for training and ... through on resolution of issues. Represent the group at provider related events and other ...
  • yesterday

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Patient Account Representative
  • Adecco
  • Palo Alto, CA
  • ... and appeals processing. * Customer service. Payment applications. Credit balance review and resolution. Patient advocacy and risk management. * Intermediate-level position for individuals with a ...
  • yesterday

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Remote Customer Service Representative
  • MDVIP
  • Henderson, NV
  • Assesses incoming service-related issues and escalates to management as needed for resolution ... that may appeal to the prospective patient. Through engaging conversations, identifies what ...
  • yesterday

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Logistics Controller
  • Treasury Wine Estate
  • Sonoma, CA
  • From the iconic luxury of Penfolds, to the broad appeal of Beringer, Etude, Sterling, Stags' Leap ... You have understanding of Continuous Improvement/Lean Concepts. (Problem- Resolution/Solving, Waste ...
  • 2 days ago

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CARE MANAGER, INPATIENT
  • Kaiser
  • Salem, OR
  • ... their appeal rights and processes if they disagree with a health care determination. Ensuring ... resolution and transition to a lower level of care; by assuring that patient/family receive right ...
  • 2 days ago

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Compliance & Benefits Manager (Human Resources)
  • FCH Enterprises Inc.
  • Honolulu, HI
  • ... resolution and compliance training sessions, resolving conflicts, disseminating policy and ... Represents the company at any unemployment hearings, appeals, and arbitrations. * Supervises the ...
  • 6 days ago

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Payment Variance Representative
  • Peregrine Team
  • Mountain View, CA
  • ... by managed care insurance payers. * Follows up on all payment variances for account resolution ... After multiple unsuccessful appeal attempts, the Payment Variance Representative is tasked with ...
  • 6 days ago

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Manager Appeal and Grievance Coordination
  • Blue Cross Blue Shield of AZ
  • Phoenix, AZ FULL_TIME
  • Awarded the Best Place to Work 2021, Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the qua...
  • 2 Months Ago

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Donor Relations Manager
  • Penny Appeal USA
  • Alexandria, VA FULL_TIME
  • Nature of Role: Full Time Location: Alexandria, VA (remote candidates will be considered) Penny Appeal USA is a relief a...
  • 6 Days Ago

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Manager Appeal and Grievance Coordination
  • Blue Cross Blue Shield of AZ
  • Phoenix, AZ FULL_TIME
  • Awarded the Best Place to Work 2021, Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the qua...
  • 2 Months Ago

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Donor Relations Manager
  • Penny Appeal USA
  • Alexandria, VA FULL_TIME
  • Nature of Role: Full Time Location: Alexandria, VA (remote candidates will be considered) Penny Appeal USA is a relief a...
  • 6 Days Ago

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Manager Software Engineering
  • Talcott Resolution
  • Windsor, CT FULL_TIME
  • Manager Software Engineering – Business Applications IT Working at Talcott Resolution* represents a unique and exciting ...
  • 18 Days Ago

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People Operations Manager
  • Resolution Life
  • Sydney, FL FULL_TIME
  • At Resolution Life, we’re proud to have evolved into a global business under the Resolution Life name. For customers, ad...
  • 2 Months Ago

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Unclaimed Property Compliance Manager
  • Resolution Life
  • West Chester, PA FULL_TIME
  • As part of the application process, a candidate account is required to log in and view application(s). Please be sure to...
  • 2 Months Ago

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Unclaimed Property Compliance Manager
  • Resolution Life
  • West Chester, PA FULL_TIME
  • As part of the application process, a candidate account is required to log in and view application(s). Please be sure to...
  • 2 Months Ago

Income Estimation for Appeal Resolution Manager jobs
$88,400 to $114,891

Career Path for Appeal Resolution Manager