Appeal Resolution Supervisor supervises a team responsible for the processing of appeals. Assigns and prioritizes cases. Being an Appeal Resolution Supervisor responds to and resolves escalated issues. Coaches and trains team in the utilization of industry standards and best practices. Additionally, Appeal Resolution Supervisor requires a bachelor's degree. Typically reports to a manager. The Appeal Resolution Supervisor supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes and procedures. To be an Appeal Resolution Supervisor typically requires 3 years experience in the related area as an individual contributor. Thorough knowledge of functional area under supervision. (Copyright 2024 Salary.com)
EDUCATION
High school graduate with business related courses. Associate's degree in a business related field preferred, or equivalent work experience.
EXPERIENCE
Three (3) to five (5) years billing or claims management experience in a hospital/healthcare computerized accounts receivable environment. Experience should include use of PCs.
SPECIAL SKILLS
Extensive knowledge of third party insurance carriers (Blue Cross, Medicare, Medicaid, Managed Care and capitated contracts) and their billing and reimbursement requirements. Excellent analytical and mathematical skills with a high degree of accuracy. Ability to perform detailed analysis quickly and accurately. Need to have keyboard skills of at lease 45 wpm and use a calculator. Ability to communicate effectively both written and verbally. PC skills including word processing, Excel, Microsoft Office, and other related software.