Appeal Resolution Specialist logs, tracks, and processes appeals and grievances. Sets up and maintains case files for each grievance and collects the information required by organizational policies and applicable regulations. Being an Appeal Resolution Specialist conducts research and coordination needed to evaluate, process, respond to, and refer or close appeals. May require an associate degree or equivalent. Additionally, Appeal Resolution Specialist typically reports to a supervisor. The Appeal Resolution Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be an Appeal Resolution Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
Cognito Systems, a Resolution Think (RT) joint venture, is seeking a skilled Credentialing Specialist. The purpose of this overall project is to provide centralized credentialing and privileging services and support to the United States Army Reserve (USAR) Command with initial entry credentialing, maintenance of credentialing and privileging, and support the Centralized Credentials Privileging Board?s review of completed credentials and privileging files.
Essential Functions and Job Responsibilities
Individuals will be responsible for managing the verification process for all healthcare professionals (physicians, dentists, nursing, allied health). This includes reviewing applications for completion, verification of state licensure, collecting information contained in the national physician data bank, collecting information from the Health Care Integrity and Protection Databank, collection of information from State Licensing activities well as their State Emergency System for Advance Registration of Volunteer Health Professionals. Job duties will specifically also include: