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4 weeks ago
The Appeals and Grievances Supervisor is responsible for leading a team that handles appeals and grievances in a healthcare setting. This role involves supervising and supporting team members, monitoring research and resolution of appeals and grievances, and ensuring thorough investigations are completed according to company policies and procedures.
Key Responsibilities- Lead and direct the team's work, monitoring research, negotiation, and resolution of appeals and grievances
- Provide support and take ownership of escalated, complex, and/or multi-issue appeals and grievances as needed
- Collaborate with internal departments to ensure timely resolution
- Analyze and trend all appeals and grievances, developing and maintaining appeal and grievance policies and procedures, workflows, member correspondence, and training as needed
- Oversee all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports
- At least 3 years of experience in a healthcare setting in Grievances and Appeals, Compliance, Claims, or Call Center
- At least 2 years of leading process, program, or staff or supervisory experience
- Ability to manage and organize large volumes of data
- Knowledge of regulatory and accreditation entities and their requirements
- Computer ease and literacy with Microsoft Office (Word, Excel, PowerPoint, Access, and Visio)
This role offers a competitive salary range of $77,000 to $123,000, as well as a comprehensive benefits package, including medical, dental, and vision insurance, HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.
Insight Global is an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances.
