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)
We are seeking a versatile individual with exceptional communication skills and proven leadership experience to join our team as a Practice Manager. The ideal candidate is self-motivated, organized, and committed to excellence and should thrive in a fast-paced, ever-changing environment and excel at managing multiple priorities. The Practice Manager must maintain a composed and reassuring presence for both patients and staff. This full-time position is based in our clinic.
The perfect candidate will have a passion for aesthetics with a desire to work closely with our staff and patients to ensure an exceptional customer experience. We offer an upbeat environment and an opportunity to be a part of helping our patients feel more confident and beautiful.
Responsibilities:
· Professionally and compassionately handle patient complaints
· Lead high-performing teams and motivate the organization toward a common goal.
· Motivating and coaching team members to meet or exceed monthly KPIs.
· Perform periodic chart reviews, monitor operations for compliance with protocols and policies. Report deviations to owner.
· Ensure staff compliance with HIPPA, OSHA, etc
· Assist in the prescreening, interviewing and onboarding process for new employees
· Develop and support a healthy team environment among departments.
· Develop and maintain systems to provide continuing education and certification for clinical providers.
· Maintain employee files and ensure compliance with federal and state human resource regulations.
· Review timesheets for all employees in Isolved, fix errors as needed, approve bi-weekly timesheets and payroll registers. Ensure proper deductions and pay rates.
· Approve/Deny PTO requests in accordance with office PTO policies.
· Manage staff aesthetic allowances
· Reports to: Practice Owner
Minimum Job Qualifications:
· Ability to perform all administrative tasks in practice to allow effective supervision and serve as back-up patient care coordinator as needed.
· Sales experience a plus
· Excellent customer service skills, and effective communication style w/high level of emotional maturity.
· Ability to lead high-performing teams and motivate an organization toward a common goal.
· Above-average judgment, integrity, discretion and trustworthiness.
Benefits & Perks:
Salary/Compensation:
Job Type: Full-time
Pay: $55,000.00 - $60,000.00 per year
Benefits:
Healthcare setting:
Schedule:
Ability to Relocate:
Work Location: In person