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Blue Cross NC

Team Leader – Appeals

Blue Cross NC

. Supervise staff processing appeals, coding disputes, grievances, and coverage/organization determinations .

Posted 9/15/2026full-timeRemote • North Carolina • United StatesSenior💰 $66,998 - $107,197 per yearWebsite

Core Competencies

Role fit
Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in appeals, coding disputes, and grievances management while ensuring compliance with regulatory and accreditation standards. Proven ability to lead teams, improve operational processes, and manage resources effectively in a healthcare environment.

Highest-signal resume keywords
Case Management SupervisionHealthcare ManagementOperational Process ImprovementsRegulatory/Accreditation Guidelines KnowledgeTeam Management

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills
Appeals ManagementCoding DisputesGrievances ManagementResource Allocation ManagementProject Management
Soft Skills
LeadershipMentorshipOrganizingPeople ManagementSupervision
Industry Keywords
Managed CarePatient CarePolicy ManagementInformation Management

About the role

Key responsibilities & impact
  • Supervise staff processing appeals, coding disputes, grievances, and coverage/organization determinations
  • Oversee daily operations, case-load assignments, and team priorities
  • Ensure resolutions comply with organizational policies, state and federal guidelines, and regulatory/accreditation requirements
  • Prepare for Appeals Committee and panel meetings
  • Handle or direct difficult customer calls regarding appeals, coding disputes, grievances, or quality issues
  • Develop efficient and effective workflows and processes with staff
  • Advise and instruct staff on operational goals, policies, and communications to providers and members
  • Evaluate data requests and ensure data requirements are met
  • Assist staff and management with information needs
  • Complete ad hoc reporting and assigned projects/interventions
  • Improve operations, resolve cross-team issues, and allocate resources across departments and divisions

Requirements

What you’ll need
  • Bachelor's degree or advanced degree (where required), or 7+ years of experience in a related field in lieu of degree
  • 5+ years of experience in a related field
  • Knowledge of appeals, coding disputes, grievances, coverage/organization determinations, and regulatory/accreditation guidelines
  • 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

Benefits

Comp & perks
  • Annual Incentive Bonus based on annual corporate goal achievement and individual performance
  • 401(k) with employer match
  • Paid Time Off (PTO)
  • Competitive health benefits
  • Wellness programs
  • Robust Total Rewards package