Senior Claims Adjustment Analyst

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🔥 0 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $55k - $60k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

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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

• Review incoming referrals daily to determine priority and distribute team assignments • Run reports from Allied’s website for departmental special projects • Determine adjustments needed and assign work accordingly • Provide training to the team as needed • Manage Blue Cross Blue Shield and Anthem adjustments • Work with other departments to determine the appropriateness of RRT referrals • Manage the BCBS and Anthem process, including adjustments and closing claims in BCBS systems • Track and handle projects timely • Update member accumulators and complete adjustments • Maintain department workflows for RRT processes • Handle high-dollar split claims, repricing adjustments, and group exception referrals • Support other units within Claim Operations • Support the refund process when needed • Perform other related duties as assigned

🎯 Requirements

• High school diploma or equivalent required • 5+ years of comprehensive experience with adjustment processing • Proficiency in Microsoft Word and Excel • Ability to easily learn other data systems • Ability to work extended periods sitting and performing computer work • Cable broadband or fiber optic internet service with at least 100Mbps download and 25Mbps upload

🏖️ Benefits

• Medical Insurance • Dental Insurance • Vision Insurance • Life Insurance • Disability Insurance • Generous Paid Time Off • Tuition Reimbursement • Employee Assistance Program (EAP) • Technology Stipend • Flexible work-from-home arrangement