Claims Admin Appeals Coordinator

Acrisure•San Diego, CA
•Onsite

About The Position

The Claims Admin Appeals Coordinator provides clerical and administrative support to the Claims Department of an insurance third-party administrator (TPA). The role supports accurate processing, organization, and maintenance of claims and assists the claims team in a fast-paced, regulated environment. The ideal candidate is detail-oriented and highly organized. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. The position requires an on-site presence to support collaboration, team leadership, and cross-functional partnership. The base compensation range is $20–$26; placement depends on factors including skills, experience, qualifications, location, and internal equity.

Requirements

  • High school diploma or equivalent.
  • One to three years of administrative or clerical experience; insurance, claims, healthcare, or legal experience is preferred.
  • Proficiency in Microsoft Office, including Word, Excel, and Outlook, and general office technology.
  • Strong data-entry skills with a high degree of accuracy.
  • Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
  • Excellent written and verbal communication skills.
  • Strong attention to detail and organizational skills.
  • Basic understanding of clerical procedures and systems such as recordkeeping and filing.
  • Ability to work independently.

Nice To Haves

  • Associate degree or coursework in business or insurance.
  • Prior experience working for an insurance carrier or third-party administrator (TPA).
  • Familiarity with claims management systems and insurance terminology.
  • Experience handling confidential or regulated information, such as HIPAA or PII.
  • Exposure to workers’ compensation, liability, or health insurance claims.
  • Proficiency in HealthPac software.

Responsibilities

  • Provide administrative support to the claims team.
  • Process and track member and provider appeals.
  • Research claims, plan provisions, and supporting documents.
  • Coordinate information needed for appeal determinations.
  • Monitor appeal deadlines and turnaround times.
  • Identify trends and recurring issues to improve the BENEX tool.
  • Support claims staff with administrative follow-up.
  • Perform other administrative and clerical duties as assigned.

Benefits

  • Comprehensive medical insurance
  • Dental insurance
  • Vision insurance
  • Life and disability insurance
  • Fertility benefits
  • Wellness resources
  • Paid sick time
  • Paid time off
  • Paid holidays
  • Employee Assistance Program (EAP)
  • Complimentary Calm app subscription
  • 401(k) plan with immediate vesting
  • Health Savings Account (HSA) options
  • Flexible Spending Account (FSA) options
  • Commuter benefits
  • Employee discount programs
  • Paid maternity leave
  • Paid paternity leave, including for adoptive parents
  • Legal plan options
  • Pet insurance coverage
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