Appeals Supervisor

Appeals Supervisor

The Appeals (Provider Relations) Supervisor is responsible for daily operations within the Provider Relations department. The Supervisor manages and prioritizes staff daily work assignments necessary to ensure the timely and accurate processing of internal and external requests along with appeal submissions. Additionally, the supervisor works to reduce response timeframes and mitigate future inquiries or escalations by being proactive, taking ownership of challenges, and formulating solutions to improve overall department activities while maintaining a focus on improving how we deliver service to our customers.

This is a remote position.

Essential Functions And Responsibilities :

• Manage team performance by setting and communicating standards and deadlines, measuring results, and providing feedback.
• Assists leadership in obtaining complex information from various financial, clinical and operational systems and data sources.
• Ability to assist with pricing of claims according to provider contracts.
• Ability to assist team with problem solving regarding customer complaints, or inquiries, including bill review disputes verbally and in written communication.
• Identifies, quantifies and monitors account detail or workflow processes for barriers. Makes process improvements or initiates courses of action for problem resolution.
• Participates in the panel interviews, prepares new hire documentation, facilitates associate orientation, and participates in the termination process (i.e., documents performance issues, recommends disciplinary actions)
• Responsible for ensuring new employees are oriented to the organization, its policies, facilities etc
• Supervisors should also provide ongoing guidance to employees, often in the forms of ongoing career coaching, counseling and performance appraisal
• Independently leads initiatives as assigned by management, coordinating task teams or other forums to deliver results as identified and / or determined by leadership. Provides formal updates and closure
• Handles escalated requests from clients and / or executive leadership
• Ensure strict confidentiality of all medical records, PHI, and PII
• Additional duties as assigned.

Knowledge & Skills :

Education / Experience :

Pay Range : $22.63 - $33.77 per hour

A list of our benefit offerings can be found on our CorVel website.