Appeals Administrative Clerk

HealthOne Alliance•Dalton, GA

2d•Onsite

About The Position

The Appeals Administrative Clerk supports the Appeals Department by performing essential administrative and data entry tasks to ensure timely and accurate processing of member appeals. This role helps maintain compliance and efficiency by entering appeals into Meditrac, uploading and organizing supporting documents, and monitoring appeals through resolution.

Requirements

High school diploma or equivalent required
1–2 years of administrative, clerical, or data entry experience in a healthcare, insurance, or related setting preferred
Proficiency with Microsoft Office Suite (Word, Excel, Outlook) and ability to learn new systems quickly
Strong attention to detail and accuracy in data entry and documentation
Excellent organizational skills with the ability to manage multiple tasks and meet deadlines
Effective written and verbal communication skills for internal correspondence and documentation
Ability to work independently as well as collaboratively in a team environment
Commitment to maintaining confidentiality and compliance with HIPAA and company policies

Nice To Haves

associate’s degree preferred
Experience with appeals, grievances, or utilization management processes a plus
Familiarity with Meditrac or similar case management/document management systems preferred

Responsibilities

Enter appeal cases accurately into Meditrac and update records as needed
Upload and attach supporting documentation to appeal files to ensure completeness
Track appeal cases from receipt through resolution, maintaining logs and status reports
Communicate with internal departments to obtain missing information or documentation
Assist in preparing correspondence and materials related to appeals processing
Ensure compliance with organizational policies, procedures, and regulatory requirements in all appeal entries and documentation
Provide general administrative support to the Appeals team including filing, scanning, and record keeping
Assist with reporting on appeals volumes, turnaround times, and other performance metrics
Support continuous improvement by identifying process efficiencies and sharing feedback with management
Maintains regular and predictable attendance
Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
Works to encourage and promote Company culture throughout the organization
Other duties as may be assigned