Appeals Specialist

Allied Benefit Systems, LLC; Chicago (IL); Remote; USD 28,000 - 29,000; Full time

Job summary

Allied Benefit Systems, LLC is seeking an Appeals Specialist to manage the organization and completion of claim appeals in a fully remote role. The position requires 3+ years of experience with medical/dental/vision claims, and proficiency in Excel and Word; Microsoft Access is a plus.

You will review appeals, prepare response letters, and maintain precise documentation while coordinating with other departments and clients.

Qualifications

• High School diploma or equivalent required.
• 3+ years of experience with billing or handling medical, dental and vision claims.
• Proficient in Microsoft Excel and Word; experience with Microsoft Access is a plus.
• Strong communication and documentation skills; able to analyze claim situations and take appropriate actions.

Responsibilities

• Review appeal and supporting documentation.
• Review Summary Plan Documents to determine validity of appeal.
• Compose appeal response letters when necessary.
• Communicate with other departments and clients as needed.
• Document appeal status and outcomes in QicLink system and related databases.
• Email claims examiners and other units as necessary.
• Prioritize incoming referrals to complete tasks timely.
• Other related duties as assigned.

Skills

Communication

Analytical thinking

Documentation

Education

High School diploma or equivalent

Tools

Excel

Word

Microsoft Access

Job description

Appeals Specialist# Appeals SpecialistFully Remote • Allied Benefit Systems - CHICAGO, IL 60606## OverviewSalary Range$20.00 - $21.00 HourlyPosition TypeFull TimeCategoryClaims## Description**POSITION SUMMARY**The Appeals Specialist will be responsible for the organization and completion of all claim appeals received in the Appeal Department.**ESSENTIAL FUNCTIONS*** 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* Other related duties as assigned# **EDUCATION*** High School diploma or equivalent required# **EXPERIENCE AND SKILLS*** 3 years or more of comprehensive experience with the billing of or otherwise handling of medical, dental and vision claims required.* Applicant should be proficient in the use of the Excel and Word programs* Experience with or ability to learn Microsoft Access* Be able to communicate effectively both orally and by email* Applicant must have the ability to analyze claim situations, take appropriate actions and be great with communication and documentation* Applicant must have a history of excellent quality results# # **POSITION COMPETENCIES*** Accountability* Communication* Customer Service Orientation* Functional/Technical Skills* Quality Focus* Time and Task Management**PHYSICAL DEMANDS*** This is a standard desk job requiring extended sitting and computer work.**WORK ENVIRONMENT*** RemoteHere at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.