Northwell Health · 1 day ago
Supervisor, Appeal Resolution
Melville, NY
Full-time
Onsite
Mid, Senior Level
$91K/yr - $158K/yr
4+ years expNorthwell Health is overseeing the operations of the centralized appeals and denial prevention process for the organization. The Supervisor of Appeal Resolution will lead a team, promote department goals, and ensure timely responses to clinical reviews and appeals.
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Responsibilities
Promotes Appeal Resolution department goals by selecting, motivating, and training capable team members
Leads the activities of assigned Appeal Resolution team members by communicating and providing guidance toward achieving department objectives
Supervises, hires, trains, disciplines, and evaluates the performance of staff; ensures performance appraisals on inpatient auditors are completed in a timely manner
Provides training to new employees; performs monthly quality reviews on staff; identifies, evaluates, and implements opportunities for efficiencies
Plans, organizes, coordinates, and evaluates staffing requirements to meet operational goals; assigns and schedules direct reports to ensure smooth and efficient workflow
Promotes staff development and education by providing opportunities for formal and informal education to promote competency; develops and performs staff educational programs; ensures staff completes annual training
Maintains data tracking systems and provides reports to staff; sets performance standards and provides ongoing feedback to staff
Generates department metrics; reports operational performance, justification, and/or corrective action
Oversees and coordinates appeals process
Reviews and evaluates cases denied by all Third Party payers and determines follow through for level of appeals; assigns cases to staff, as appropriate
Monitors inpatient denials and assists patients and physicians with management of the appeals process
Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions
Qualification
Required
Graduate from an accredited School of Nursing required
Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed
4-6 years of relevant experience and 0-2 years of leadership / management experience, required
Preferred
BSN from an accredited school of nursing
Company
Northwell Health
Northwell Health is New York State’s largest health care provider and private employer, with 28 hospitals, about 1,000+ outpatient facilities and more than 16,000 affiliated physicians.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$58.3MKey Investors
National Institute of Mental HealthNational Human Genome Research InstituteBreakthrough Discoveries
2025-12-02Grant· $4M
2025-10-23Grant· $3.2M
2025-06-16Grant· $2.3M
Leadership Team
Michael Dowling
President and CEO
Nick Stefanizzi
Chief Executive Officer at Northwell Direct
Recent News
Morningstar.com
2025-12-15
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