Job Description

Key Responsibilities

The Appeals Administrator is responsible for managing the appeals process, ensuring fair and timely resolution of disputes.

Key Responsibilities Include:

Case Management: Receive, log, and acknowledge appeals in a timely manner. Maintain accurate and up-to-date records of all appeal-related activities. Investigation and Analysis: Conduct thorough investigations of appeals, gathering relevant information and documentation from all parties involved. Communication: Serve as a primary point of contact for appellants, providing clear and concise information about the appeals process and status updates. Resolution: Facilitate the resolution of appeals through negotiation, mediation, or other appropriate methods. Prepare and issue written decisions that are clear, concise, and well supported. Compliance: Ensure that all appeals are processed in accordance with company policies, and applicable laws and regulations. Reporting: Prepare regular reports on appeals activity, including trends, outcomes, and recommendations for process improvements. Collaboration: Work closely with other departments, such as legal, compliance, and customer service, to ensure effective resolution of appeals. Process Improvement: Identify opportunities to streamline the appeals process and improve efficiency and effectiveness.

Required Qualifications

To be considered for the Appeals Administrator position, candidates must possess the following qualifications:

Experience: Minimum of 3 years of experience in appeals administration, dispute resolution, or a related field. Knowledge: Strong understanding of appeals processes, legal and regulatory requirements, and dispute resolution techniques. Skills: Excellent communication, analytical, and problem-solving skills. Ability to work independently and as part of a team. Proficiency in Microsoft Office Suite and case management software.

Desired Skills

The following skills are highly desirable for the Appeals Administrator position:

Negotiation and Mediation: Proven ability to negotiate and mediate disputes to reach mutually agreeable resolutions. Legal Acumen: Familiarity with relevant laws and regulations related to appeals and dispute resolution. Customer Service: Strong customer service skills, with the ability to handle sensitive situations with empathy and professionalism. Attention to Detail: Exceptional attention to detail and accuracy in all aspects of work. Organisational Skills: Excellent organisational and time management skills, with the ability to prioritise tasks and meet deadlines. Conflict Resolution: Experience in conflict resolution and de-escalation techniques.
Job Types: Full-time, Permanent

Pay: 24,500.00-27,840.00 per year

Work Location: In person