Appeal Resolution Senior Manager Jobs

Directs the overall grievance and appeal process operations that encompass the review, investigation, negotiation and processing of disputed medical, insurance, and other claims. Ensures that work activities are compliant with all regulatory guidelines and policy protocols. Allocates resources to ensure an effective and efficient case workload that achieves operational objectives. Provides expert subject matter guidance and may represent the organization at hearings. Requires a bachelor's degree. Typically reports to a senior manager or head of a unit/department. Typically manages through subo ... rdinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. More
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