Appeals Specialist

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Oversee the organization and execution of all claim appeals received by the Appeal Department.

• Examine appeal submissions along with the accompanying documentation.

• Analyze Summary Plan Documents to assess the legitimacy of the appeal.

• Draft appeal response letters when required.

• Liaise with other departments and clients as necessary.

• Record the status and outcomes of appeals in the QicLink system and database.

• Communicate via email with claims examiners and other units when needed.

• Manage incoming referrals to ensure all tasks are completed promptly.

• Carry out additional related tasks as assigned.

⛳️ Requirements

• High School diploma or equivalent is mandatory.

• A minimum of 3 years of extensive experience in billing or managing medical, dental, and vision claims is required.

• Proficiency in using Excel and Word applications.

• Familiarity with or willingness to learn Microsoft Access.

• Must be able to communicate effectively, both verbally and through email.

• Strong analytical skills to assess claim situations, take appropriate actions, and excel in communication and documentation.

• Proven track record of delivering high-quality results and a willingness to embrace new challenges if currently employed at Allied.

🏝️ Benefits

• Medical

• Dental

• Vision

• Life & Disability Insurance

• Generous Paid Time Off

• Tuition Reimbursement

• EAP

• Technology Stipend