| Appeal Resolution Director Job Description |
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| The following is a full job description for Appeal Resolution Director. Here are the requirements and responsibilities for Appeal Resolution Director along with statistics. If after reading this page you determine that Appeal Resolution Director is not the position you are looking for, you may want to try one of these similar titles: Appeal Resolution Nurse, Appeal Resolution Specialist, Appeal Resolution Supervisor, Appeal Resolution Senior Specialist, Appeal Resolution Manager, Channel Sales Director, Product Design Director, Software Systems Development Director, Systems Administration Director |
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| Requirements and Responsibilities For Appeal Resolution Director |
| 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 senior management. Manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. |
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| Also referred to as: Grievance and Appeals Resolution Director |
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| Similar Jobs: Appeal Resolution Nurse, Appeal Resolution Specialist, Appeal Resolution Supervisor, Appeal Resolution Senior Specialist, Appeal Resolution Manager, Channel Sales Director, Product Design Director, Software Systems Development Director, Systems Administration Director |
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| Level of Education: Appeal Resolution Director Salaries with No Diploma, Appeal Resolution Director Salaries with a High School Diploma or Technical Certificate, Appeal Resolution Director Salaries with an Associate's Degree, Appeal Resolution Director Salaries with a Bachelor's Degree, Appeal Resolution Director Salaries with a Master's Degree or MBA, Appeal Resolution Director Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Edu., Gov't. & Nonprofit, Healthcare, Insurance | |
