Appeal Resolution Supervisor supervises a team responsible for the processing of appeals. Assigns and prioritizes cases. Being an Appeal Resolution Supervisor responds to and resolves escalated issues. Coaches and trains team in the utilization of industry standards and best practices. Additionally, Appeal Resolution Supervisor requires a bachelor's degree. Typically reports to a manager. The Appeal Resolution Supervisor supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes and procedures. To be an Appeal Resolution Supervisor typically requires 3 years experience in the related area as an individual contributor. Thorough knowledge of functional area under supervision. (Copyright 2024 Salary.com)
Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.
Job Summary:
A successful candidate in this role will exhibit proficiency in taking initiative, attention to detail, communication (verbal and written communication), process orientation, teamwork and accountability. A unique blend of technical skill and business process savvy is required to be successful at this position, along with excellent analytical skills. This candidate must lead by example and be a change agent.
Specific Duties:
· Responsible for timely and effective handling of all inquiries from partners and clients within the framework of the established performance guarantee for each partner and client.
· Ensures that all partner and client (including management) incoming inquiries are answered promptly, thoroughly, professionally and accurately
· Be an effective resource for team members, clarifying questions, supporting and enforcing departmental policies and procedures
· Builds and maintains strong positive relationships with internal and external customers and partners.
· Work closely and serves as primary liaison with all internal departments (e.g. Claims, Billing, etc.…)
· Monitors aging of inquiries to ensure that department KPIs are met and/or exceeded
· Ensures quality of responses are maintained and provides constructive feedback to staff to drive positive results
· Partners with Team Lead on coaching and developing team as well as working with established teams to drive business and look for areas of improvement
· Attendance management experience; Manage attendance policy at team and center level to meet performance
· Provides work leadership, assistance and training to all those supervised
· Partners with management team on recruitment, interviewing and recommendation of new team members
· May perform other duties as required by management
· Ability to work from home, which includes wi-fi capability and a quiet, confidential workspace.
Qualifications
· Performance and Results driven
· Must have ability to manage organize, plan and provide leadership to staff
· Ability to develop and motivate staff to facilitate professional growth.
· Must possess tact, diplomacy, and professionalism to effectively handle and deescalate all internal and external issues
· Excellent knowledge or ability to develop such knowledge of Claims, Enrollment, Self-funded billing, benefits, and Customer within the Healthcare industry.
· Proven ability to interface with internal/external customers and management at various levels.
· Ability to think critically and resolve inquiries.
· Excellent initiative taking and thinking out of the box abilities
· Proficient with Microsoft Excel, Access, Word, PowerPoint and Outlook.
· Excellent listening, written and verbal communication skills.
· Ability to multitask and prioritize activities.
· Ability and willingness to work in fast-paced, dynamic and challenging environment
· Ability to effectively and efficiently meet and/or exceed time sensitive deliverables
· Excellent attention to detail, analytical skill and ability to execute assignments with minimal guidance
Ø Education & Experience:
· Associate degree in a Business-related field or equivalent work experience preferred.
· Minimum of 5 years working within the Healthcare industry.
· Minimum of 2-3 years of prior Supervisory Call Center related experience.
Hybrid of Choice:
Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.