Remote Claims Appeals Specialist

Allied Benefit Systems; Chicago (IL); On-site; USD 55,000 - 75,000; Full time

Job summary

Allied Benefit Systems is seeking an Appeals Specialist responsible for organizing and completing all claim appeals in the Appeal Department. The role emphasizes accurate documentation and timely processing from a remote-friendly environment.

You will review appeals, validate against Summary Plan Documents, and communicate with multiple teams to ensure proper handling and response to claim actions. A high level of attention to detail and professional written communication is essential.

Qualifications

• Strong communication skills via email and verbally.
• Ability to analyze claim situations and determine required actions.
• Experience handling medical, dental and vision claims processes.

Responsibilities

• Review appeal and supporting documentation.
• Determine validity of appeal via Summary Plan Documents.
• Compose appeal response letters when necessary.
• Communicate with other departments and clients.
• Document appeal status and outcomes in QicLink system and database.

Skills

Communication

Analytical thinking

Documentation

Education

High School diploma or equivalent

Tools

Excel

Word

Microsoft Access

Job description

Allied Benefit Systems is seeking an Appeals Specialist responsible for organizing and completing all claim appeals in the Appeal Department. The role emphasizes accurate documentation and timely processing from a remote-friendly environment.

You will review appeals, validate against Summary Plan Documents, and communicate with multiple teams to ensure proper handling and response to claim actions. A high level of attention to detail and professional written communication is essential.