Remote Claims Appeals Specialist

Allied Benefit Systems; Chicago (IL); Remote; USD 50,000 - 70,000; Full time

Job summary

Allied Benefit Systems is seeking an Appeals Specialist to organize and complete claim appeals in the Appeal Department. The role focuses on reviewing appeals and supporting documentation, determining validity, and composing response letters when needed.

You will communicate with other departments and clients, document the QicLink system with outcomes, and prioritize referrals to ensure timely completion. The position supports a remote-friendly environment with emphasis on data quality and

Qualifications

• 3+ years in billing or handling medical, dental, and vision claims.
• Proficient with Excel and Word.
• Experience with or ability to learn Microsoft Access.
• Strong written and spoken communication.
• Ability to analyze claim situations and document clearly.
• History of excellent quality results.

Responsibilities

• Review appeal materials and supporting documentation.
• Review Summary Plan Documents to determine validity of appeal.
• Draft appeal response letters when necessary.
• Communicate with other departments and clients when necessary.
• Document the QicLink system and database with appeal status and outcome.
• Email claims examiners and other units when necessary.
• Prioritize incoming referrals to complete all tasks timely.
• Other related duties as assigned.

Skills

Medical claims

Excel

Word

Access

Communication

Documentation

Quality focus

Education

High School diploma

Tools

Excel

Word

Microsoft Access

Job description

Allied Benefit Systems is seeking an Appeals Specialist to organize and complete claim appeals in the Appeal Department. The role focuses on reviewing appeals and supporting documentation, determining validity, and composing response letters when needed.

You will communicate with other departments and clients, document the QicLink system with outcomes, and prioritize referrals to ensure timely completion. The position supports a remote-friendly environment with emphasis on data quality and