Note: The job is a remote job and is open to candidates in USA. Allied Benefit Systems is a company focused on healthcare solutions, and they are seeking a Remote Healthcare Appeals Specialist. The Appeals Specialist will be responsible for organizing and completing all claim appeals received in the Appeal Department.
Responsibilities
- 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
Skills
- High School diploma or equivalent required
- 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
- 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
- Experience with or ability to learn Microsoft Access
- A history of excellent quality results and the desire to take on a new challenge if currently employed at Allied
Benefits
- Medical, Dental, Vision, Life & Disability Insurance
- Generous Paid Time Off
- Tuition Reimbursement
- EAP
- Technology Stipend
Company Overview