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)
PLEASE NOTE: THIS IS AN IN PERSON POSITION. NOT AVAILABLE FOR REMOTE WORK.
Case Document Specialist: Our firm conducts employment discrimination investigations for the federal government. This position is in the publishing unit of our organization, finalizing our reports of investigation. This position requires an attention to detail, strong word processing skills, excellent grammar and proof-reading skills, and requires extensive work with Adobe Acrobat. This position also requires excellent written and verbal communication skills in order to interact with the clients and staff members. Because we work with highly sensitive government information, a background clearance is required by our clients.
Responsibilities
The duties of this position include proof-reading and formatting the completed reports of investigation; digitizing the reports in Adobe Acrobat (including bookmarking, page numbering, ensuring 508 compliance, etc.); and redacting Privacy Act information from such reports. Responsibilities also include communicating with the staff and clients both in writing and over the phone.
Qualifications
Qualifications needed include an attention to detail, strong word processing skills, excellent grammar and proof-reading skills, and either experience in or the ability to learn Adobe Acrobat. Excellent verbal and written communication skills required. Must be able to pass a federal government background clearance.