Team Leader – Appeals

🔥 16 hours ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $67k - $107.2k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Blue Cross NC

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1933

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Blue Cross NC is a health insurance provider that offers a range of health plans and services to individuals and groups. The company focuses on delivering quality healthcare coverage and improving health outcomes for its members through innovative health programs and services. Blue Cross NC is committed to enhancing access to affordable healthcare while supporting the health and wellness of the communities it serves.

📋 Description

• Supervise staff processing appeals, coding disputes, grievances, and coverage/organization determinations • Oversee daily operations, case-load assignments, and team priorities • Ensure resolutions comply with organizational policies, state and federal guidelines, and regulatory/accreditation requirements • Prepare for Appeals Committee and panel meetings • Handle or direct difficult customer calls regarding appeals, coding disputes, grievances, or quality issues • Develop efficient and effective workflows and processes with staff • Advise and instruct staff on operational goals, policies, and communications to providers and members • Evaluate data requests and ensure data requirements are met • Assist staff and management with information needs • Complete ad hoc reporting and assigned projects/interventions • Improve operations, resolve cross-team issues, and allocate resources across departments and divisions

🎯 Requirements

• Bachelor's degree or advanced degree (where required), or 7+ years of experience in a related field in lieu of degree • 5+ years of experience in a related field • Knowledge of appeals, coding disputes, grievances, coverage/organization determinations, and regulatory/accreditation guidelines • Case Management Supervision • Department Management • Employee Supervision • Healthcare Management • Information Management • Leadership • Managed Care • Mentorship • Operational Process Improvements • Organizing • Patient Care • People Management • Policy Management • Project Management • Resource Allocation Management • Resource Management • Supervision • Team Management • Utilization Management

🏖️ Benefits

• Annual Incentive Bonus based on annual corporate goal achievement and individual performance • 401(k) with employer match • Paid Time Off (PTO) • Competitive health benefits • Wellness programs • Robust Total Rewards package