Essential Functions-Supervises the daily operations of the claims resolution team, including work assignments, training, coaching, and performance management.-Manages the inventory of provider review requests and claims projects, monitoring volume, aging, and completion to ensure timely resolution.-Prioritizes and distributes work based on deadlines, complexity, staff capacity, and operational needs.-Oversees the review of finalized claims submitted for reconsideration through provider forms, phone calls, and other channels.-Identifies trends in review requests, claim outcomes, and inventory; escalates recurring issues and recommends corrective actions.-Coordinates with payers and internal departments as needed to research claim issues and reach accurate resolutions.-Develops and maintains procedures that support consistent reviews, clear documentation, and efficient inventory management.-Ensures the team’s work complies with applicable federal and state requirements and organizational policies.-Prepares reports on inventory, turnaround times, staff productivity, and resolution outcomes, and identifies opportunities for improvement. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.