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 2024 Salary.com)
OPPORTUNITIES TO IGNITE YOUR PASSION, CRC services include Intelligence Analysis, Business Management, Cyber Operations, and Information Technology Consulting Services to the Department of Defense (DoD), Intelligence Community (IC) and other Federal Agencies. We offer a wide range of career opportunities and exceptional benefits.
JOB SUMMARY: CRC has an immediate opening for a Workflow Management Specialist within the Air Force Surgeon General’s (AF/SG) Office in Falls Church, Virginia.
DESCRIPTION: In support of the U.S. Air Force Surgeon General’s Executive Service (SGE) Office at the Defense Health Headquarters, (DHHQ), the candidate will provide workflow task quality, capacity management workflow and support services for publication management in conjunction with the Workflow Management functions of the Executive Services, for the U.S. AF/SG. The candidate also manages all correspondence for quality; ensuring content standards are adhered to, and set appropriate suspense dates for inquiries received from agencies outside the SG Office to include Members of Congress, Secretary of Defense, Joint Staff, Major Commands (MAJCOM), Field Operating Agencies (FOA), Direct Reporting Units (DRU) and agencies within the National Capital Region (NCR). The candidate provides task management support for over 500 active duty military and civilian personnel assigned to the AF/SG portfolio.
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Clear Resolution Consulting (CRC), our employees are the heart and spirit of our company. We rely on their dedication to excellence and their knowledge of our client’s requirements to help them meet their most complex challenges . Our employees' blend of technical skills, innovation and dedication drives our continued success, and we take our responsibility to them seriously.
At CRC you'll find a fulfilling career and a great place to work — one that challenges you, fuels your need for creativity and innovation, and inspires teamwork and mutual respect. We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, any other non-merit factor, or any other characteristic protected by law.
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