Appeals Specialist

Allied Benefit Systems • Chicago, IL

49d • $20 - $21 • Remote

About The Position

The Appeals Specialist organizes and completes all claim appeals received in the Appeal Department. The role reviews appeals and supporting documentation, assesses appeal validity against Summary Plan Documents, and prepares response letters when needed. The specialist communicates with other departments and clients, records appeal status and outcomes in QicLink and the database, and prioritizes incoming referrals to complete work on time. Other related duties may be assigned.

This is a remote position. The role is a standard desk job involving extended sitting and computer work. A cable broadband or fiber internet connection with speeds of at least 100 Mbps download and 25 Mbps upload is required.

The position is full-time, with an hourly salary range of $20.00–$21.00. Allied offers a benefits package that includes medical, dental, vision, life and disability insurance, paid time off, tuition reimbursement, an employee assistance program, and a technology stipend.

Requirements

• High school diploma or equivalent.
• At least 3 years of comprehensive experience billing or otherwise handling medical, dental, and vision claims.
• Proficiency with Microsoft Excel and Word.
• Ability to communicate effectively orally and by email.
• Ability to analyze claim situations, take appropriate action, and maintain strong communication and documentation.
• History of producing excellent-quality results.

Nice To Haves

• Experience with Microsoft Access, or the ability to learn it.

Responsibilities

• Review appeal submissions and supporting documentation.
• Review Summary Plan Documents to determine the validity of appeals.
• Compose appeal response letters when necessary.
• Communicate with other departments and clients when necessary.
• Document appeal status and outcomes in QicLink and the database.
• Email claims examiners and other units when necessary.
• Prioritize incoming referrals to complete tasks in a timely manner.
• Perform other related duties as assigned.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Life insurance
• Disability insurance
• Generous paid time off
• Tuition reimbursement
• Employee assistance program (EAP)
• Technology stipend

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED