Claims Appeals Specialist

Unified Group Services; Anderson (IN); On-site; USD 40,000 - 60,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

401(k) with company match

Education assistance

Employee assistance program

PTO

Growth opportunities

HSA/FSA

Life insurance

Short- and long-term disability

Wellness programs

Sponsored health clinic

Company parties

Job summary

Unified Group Services in Anderson, IN is seeking a full-time Claims Appeals Specialist to join our team. This role focuses on researching and resolving complex appeals, ensuring accurate determinations for members and clients.

You will collaborate with internal reviewers and IROs, draft clear response letters, and maintain timely communication with providers, members, and vendors. The ideal candidate has strong analytical skills, attention to detail, and the ability to meet deadlines.

Qualifications

• High school diploma or equivalent.
• Proficiency in MS Word, Excel and Outlook.
• Strong mathematical and analytical skills.
• Exceptional attention to detail.
• Ability to meet critical deadlines.
• Excellent writing skills preferred.

Responsibilities

• Investigate and review internal and external appeals related to benefit determinations, Usual & Customary reductions, discount disputes and eligibility concerns.
• Collaborate with internal review vendors and IROs to ensure accurate and efficient handling of appeals.
• Draft professional letters to providers, members, representatives, and attorneys; maintain clear communication with claims processors and clients.

Skills

Analytical skills

Attention to detail

Deadline-oriented

MS Word

Excel

Outlook

Strong writing skills

Education

High school diploma or equivalent

Tools

MS Word

Excel

Outlook

Job description

Do you enjoy solving complex claim challenges, uncovering answers others might overlook, and playing a key role in delivering fair, accurate outcomes? Unified Group Services is seeking a full-time Claims Appeals Specialist to join our team in Anderson, IN. This is an exciting opportunity for a detail-oriented professional who thrives on research, analysis, collaboration, and meaningful work that directly impacts members and clients. If you're ready to put your problem-solving skills to work in a rewarding career with a respected organization, apply today!

Pay: We offer our Claims Appeals Specialist a competitive wage, based on experience.

Benefits:

• Health, dental, and vision insurance
• 401(k) with company match
• Education assistance
• Employee assistance program
• PTO
• Growth opportunities
• HSA/FSA
• Life insurance
• Short- and long-term disability coverage
• Wellness programs
• Sponsored health clinic
• Company parties

WANT TO KNOW MORE ABOUT OUR BUSINESS?

At Unified Group Services, we take care of the customer, and then some! Established in 1996, we're a proud full-service third-party administrator (TPA) for self-funded group health insurance plans. Our mission is centered on you-whether you're a customer or a team member-because we believe that great service starts with a great culture. We empower our customers with innovative programs, cutting-edge technology, and trusted partnerships that help control healthcare costs while ensuring access to top-tier benefits. Every service we deliver is backed by a professional, experienced team that provides personal attention with speed and care. We don't just talk about our values-we live them, training every employee to uphold the principles that have guided us from the beginning. If you're looking to join a company where your work truly makes a difference, Unified Group Services is the place to be.

DO YOU MEET THESE QUALIFICATIONS?

• High school diploma or equivalent
• Proficiency in Microsoft Word, Excel, and Outlook
• Strong mathematical and analytical skills
• Exceptional attention to detail
• Ability to meet critical deadlines

Excellent writing skills with strong grammar and punctuation, effective problem-solving and decision-making abilities, a self-motivated mindset, adaptability, reliable attendance, and a commitment to supporting team goals are preferred.

WHAT WILL YOU DO AS A CLAIMS APPEALS SPECIALIST?

As our full-time Claims Appeals Specialist, you'll spend your day investigating and reviewing internal and external appeals related to benefit determinations, Usual & Customary reductions, discount disputes, and eligibility concerns. You'll collaborate closely with internal review vendors and Independent Review Organizations (IROs), helping ensure every appeal is handled accurately and efficiently. You'll also draft professional response letters to providers, members, representatives, and attorneys, while maintaining regular communication with claims processors, reinsurers, vendors, providers, members, clients, and legal representatives.

READY TO APPLY AND ADVANCE YOUR CAREER?

Join Unified Group Services and become an important part of a team that makes a meaningful impact every day. Apply now! Our initial application process is fast, simple, and mobile-friendly.