Manager of Appeals Operations

Job Summary

Overseeing the Appeals Shipment Teams, the full-time Manager will manage supervisors, ensure operational efficiency, and enhance workflows in a remote environment while maintaining quality assurance and regulatory adherence.

Key responsibilities

• Manage the quality assurance and operational efficiency of pre and post-shipment workflows
• Facilitate communication between internal teams, clients, and payers to ensure professional correspondence
• Analyze performance metrics and implement process improvements to enhance appeal success rates

Required qualifications

• Experience in multi-payer, multi-state appeals operations
• Familiarity with Payer Portals and workflow automation tools
• Experience in implementing standard operating procedures (SOPs) and quality assurance programs
• Proven track record in process improvement initiatives
• Ability to utilize reporting tools like Salesforce and Power BI for data analysis