Manager of Appeals Operations

Job Summary

A company is looking for a Manager-Central Appeals Office.

Key Responsibilities

• Oversee all appeal inventory and productivity across all markets, ensuring timely completion of appeals
• Assist with training and mentorship of Market Appeals Specialist/Appeals Support Specialist
• Support initiatives that drive performance improvement through technology advancements

Required Qualifications, Training, and Education

• Bachelor's degree required; Master's preferred
• 5-8 years of related experience required; 8-10 years preferred
• Ability to apply practice management guidelines for medical necessity and appropriateness of care
• Subject matter expertise in managing the appeal and denial process
• Clinical experience and understanding of internal operations of a behavioral health hospital