Appeals Team Lead - Resolve, Guide & Optimize

Blue Cross NC; North Carolina; On-site; USD 67,000 - 107,000; Full time

Benefits offered by this job

Annual Incentive Bonus

401(k) with employer match

Paid Time Off (PTO)

Health benefits and wellness programs

Job summary

Blue Cross NC is seeking a Team Leader, Appeals in North Carolina to supervise the resolution of appeals, coding disputes and grievances in line with policies and guidelines. You will oversee daily operations and assign workloads to the team, ensuring timely and accurate outcomes.

The role requires a Bachelor’s or advanced degree or equivalent experience, with 5+ years in related work. Salary ranges from $66,998 to $107,197 and a robust Total Rewards package including bonus and retirement

Qualifications

• Bachelor's degree or advanced degree is required.

Responsibilities

• Supervise staff processing appeals, coding disputes and grievances.
• Set priorities and guide the team to meet organizational goals.
• Prepare for Appeals Committee and panel meetings.
• Handle difficult calls regarding appeals and grievances or quality issues.
• Instruct staff on provider/member communications and decisions.

Skills

Experience

Education

Bachelor's degree

Advanced degree

Job description

Blue Cross NC is seeking a Team Leader, Appeals in North Carolina to supervise the resolution of appeals, coding disputes and grievances in line with policies and guidelines. You will oversee daily operations and assign workloads to the team, ensuring timely and accurate outcomes.

The role requires a Bachelor’s or advanced degree or equivalent experience, with 5+ years in related work. Salary ranges from $66,998 to $107,197 and a robust Total Rewards package including bonus and retirement