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)
No experience necessary, we will teach you! Must be bilingual in Spanish. Great entry-level opportunity for anyone wanting to gain knowledge and experience in financial services. Ideal for college students and high school graduates trying to build a resume.
PCRI is a locally owned small business offering a warm, friendly workplace environment. We are looking for a teammate who considers themselves to be positive, dependable, mature, and efficient. We need someone who would enjoy a place to contribute their bilingual talents working with consumers to help educate and facilitate resolution of balances owed as well as researching information via websites and other means. We teach and train you to manage your own caseload. We go the extra mile to make a difference and we work hard together as a team. If you are ethical, detail-oriented, good at collaborative problem solving, and have a desire to grow and be successful, PCRI is the place for you! Enjoy a nice office atmosphere and free parking. Qualifications include: Must be bilingual in Spanish. Strong attention to detail, excellent listening and communication aptitudes, proficient computer and keyboarding skills. High School Diploma or GED equivalent required.
Benefits include: Excellent Compensation Package, Paid Time-Off, Life and Disability Insurance, Tuition Reimbursement, Retirement Package that includes profit sharing and 401K, Flexible Schedule.
Job Types: Full-time, Part-time
Pay: $33,000.00 - $38,000.00 per year
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Work Location: In person