Remote Healthcare Appeals Specialist

 Posted 4 days ago
     
 $20 - $21 per hour
  
2-5 years experience
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AI Summary

The Appeals Specialist is responsible for organizing and completing all claim appeals received in the department. This includes reviewing supporting documentation, composing response letters, and documenting outcomes in the QicLink system.
Job DetailsJob Location: Allied Benefit Systems - CHICAGO, IL 60606Position Type: Full TimeSalary Range: $20.00 - $21.00 HourlyJob Category: ClaimsPOSITION 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  Performs 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 and the desire to take on a new challenge if currently employed at Allied.  POSITION COMPETENCIES:  Accountability  Communication  Customer Service Orientation  Functional/Technical Skills  Quality Focus  Time and Task Management  PHYSICAL DEMANDS:  This is a standard desk role – long periods of sitting and working on a computer are required.  WORK ENVIRONMENT:   Remote  Here 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 & 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. Qualifications

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