Appeals Specialist

🔥 3 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $20 - $21 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Allied Benefit Systems

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1980

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Allied Benefit Systems is a national healthcare solutions company that provides health plan administration, care and cost management, provider network services, and data analytics to employers, members, and benefits consultants. The company focuses on reducing healthcare costs, optimizing plan performance, and improving member experience through administrative services, analytics & insights, and customizable provider networks.

📋 Description

• Responsible for the organization and completion of all claim appeals received in the Appeal Department • Reviewing appeal and supporting documentation • Reviewing Summary Plan Documents to determine validity of appeal • Composing appeal response letters when necessary • Communicating with other departments and clients when necessary • Documenting the QicLink system and database with appeal status and outcome • Emailing claims examiners and other units when necessary • Prioritize incoming referrals to complete all tasks timely • Performs other related duties as assigned

🎯 Requirements

• High School diploma or equivalent required • 3 years or more of comprehensive experience with the billing of or otherwise handling of medical, dental and vision claims required • Proficient in the use of Excel and Word programs • Experience with or ability to learn Microsoft Access • Be able to communicate effectively both orally and by email • Ability to analyze claim situations, take appropriate actions and be great with communication and documentation • History of excellent quality results and desire to take on a new challenge if currently employed at Allied.

🏖️ Benefits

• Medical • Dental • Vision • Life & Disability Insurance • Generous Paid Time Off • Tuition Reimbursement • EAP • Technology Stipend