Appeals & Grievances Team Lead

Blue Cross and Blue Shield of North Carolina; North Carolina; Hybrid; USD 67,000 - 107,000; Full time

Job summary

Blue Cross and Blue Shield of North Carolina is seeking a Team Leader for Appeals to supervise the processing of appeals, coding disputes and grievances, ensuring alignment with policies and state/federal guidelines.

The role oversees daily operations, workload priorities, and coordination with regulators and leadership, while guiding staff toward efficient workflows and policy-compliant decisions. Hybrid flexibility is offered.

Qualifications

• Bachelor's degree or advanced degree (where required) 5+ years of experience in related field.
• In lieu of degree, 7+ years of experience in related field.

Responsibilities

• Supervise staff handling appeals, coding disputes, and grievances and related determinations.
• Assign workload, set priorities, and improve workflows.
• Prepare for Appeals Committee meetings and interact with regulators.
• Provide guidance and coaching to staff on policies and operational goals.

Skills

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

Education

Bachelor's degree or advanced degree

Job description

Blue Cross and Blue Shield of North Carolina is seeking a Team Leader for Appeals to supervise the processing of appeals, coding disputes and grievances, ensuring alignment with policies and state/federal guidelines.

The role oversees daily operations, workload priorities, and coordination with regulators and leadership, while guiding staff toward efficient workflows and policy-compliant decisions. Hybrid flexibility is offered.