Appeals Supervisor Cover Letter

Please consider me for the appeals supervisor opportunity. I am including my resume that lists my qualifications and experience.

Previously, I was responsible for overall supervisory and technical support to the Patient Financial Services team and for the billing processes for a large variety of payers for both inpatient and outpatient receivables.

My experience is an excellent fit for the list of requirements in this job:

• Promotes staff development and education by providing opportunities for formal and informal education to promote competency
• Develops and performs staff educational programs
• Maintains current knowledge of all IPRO, Managed Care and Third Party Review requirements
• In-depth knowledge of the appeals and denial processes
• Current and unrestricted Pharmacy Technician License in the state of Arizona
• Knowledge of health insurance products and services
• Skill at legal research, evauating legal issues and conducting administrative hearings
• The Appeals Referee Supervisor supervises the Special Deputies-Team Leads in the district appeals offices

I am excited to be applying for the position of appeals supervisor. Please accept this letter and the attached resume as my interest in this position.

In the previous role, I was responsible for guidance and direction to District administration regarding the Student Code of Conduct and related District policies and procedures.

Please consider my experience and qualifications for this position:

• Verbal and written communication with our customers including the Centers for Medicare and Medicaid Services (CMS), providers, and beneficiaries
• Experience using claims process system
• Active Pharmacy Tech License in good standing
• Knowledge of the Pharmacy Benefit Management and/or Health Insurance Industry from a customer support perspective
• Working knowledge of word processing, spreadsheet, and familiarity with scheduling software applications
• Adaptable and able to move with change while maintaining a positive attitude and strong role model for the Team
• Knowledge of Call Center industry through work experience and as obtained through courses provided by ICMI or CIAC
• Working knowledge of Medicare Part D, CMS regulations, NCQA, and State regulations

I am excited to be applying for the position of appeals supervisor. Please accept this letter and the attached resume as my interest in this position.

In the previous role, I was responsible for oversight of level 1 and level 2 appeals process to ensure compliance with applicable complaint and appeals policies.

Please consider my qualifications and experience:

• RN Licensure within the State of Florida or Multi-State Enhanced Nursing License Compact (ENLC) – maintain active and in good standing throughout employment
• Prior medical or claims coding experience preferred
• Prior medical claims review experience preferred
• Prior experience in CMC or Member/Provider Appeals preferred
• Prior leadership experience also preferred
• Demonstrated excellent leadership, organizational, interpersonal and written/verbal communication skills
• Demonstrated experience in inventory management and reporting via insinq
• Government Program Experience Preferred (Medicare and Medicaid)

In response to your job posting for appeals supervisor, I am including this letter and my resume for your review.

In my previous role, I was responsible for oversight for the provision of care in our 60 bed acute care hospital and 62 bed residential facility.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Experience with CMS guidance and regulations strong preferred
• Demonstrate strong data entry and typing skills with proficiency in the use of a PC
• Preferred Other Previous experience working in a supervisory, lead, or senior capacity that involved mentoring or training of others
• Bachelors in Pharmacy or Pharm D
• Active, unrestricted Pharmacist license in state of practice
• Experience in Commercial (private), and/or Medicare Part D prescription drug plans, programs or formularies
• Verbal and written communication with Director and Senior Management, peers, departmental staff, and various Corporate support departments
• Verbal and written communication with external business partners including Program Safeguard Contractors (PSC), Recovery Audit Contractors (RAC), and Qualified Independent Contractors (QIC) and vendors

I am excited to be applying for the position of appeals supervisor. Please accept this letter and the attached resume as my interest in this position.

In the previous role, I was responsible for the decisions for appeals via letter, within the compliance timeframes, based on the regulatory requirements and guidelines for the appeal process.

My experience is an excellent fit for the list of requirements in this job:

• Experience working as a lead or supervisor, or equivalent experience within a team of pharmacists including managing operations of a work unit
• Previous experience working in a supervisory, lead, or senior capacity that involved mentoring or training of others
• Microsoft Excel Working knowledge of Microsoft Office Products including Outlook, Word and Excel
• Previous experience working in the healthcare industry or medical field
• Advanced proficiency in Microsoft Office programs including Word, Excel, and Outlook
• Previous experience working in Grievance and Appeals
• Beginner knowledge in Microsoft PowerPoint and Access
• Proficiency with Microsoft Word, Excel, PowerPoint, Outlook, and Share Point