[Hiring] Appeals Coordinator @Allied Benefit Systems

Role Description

The Appeals Specialist is responsible for monitoring and tracking the status of appeals as they relate to the Allied Advocate program. The position involves but is not limited to:

• Reviewing appeals for appropriateness
• Documenting the claim specifics into the current software
• Routing documentation to business partners for review/resolution
• Providing follow-up with business partners on aging appeals
• Coordinating with Allied business partners for documenting and tracking appeals

Qualifications

• Bachelor’s degree or equivalent work experience required
• 2 years of comprehensive experience with the handling of medical claims appeals required
• Proficient with Microsoft Office Suite or related software required
• Ability to analyze claim situations and take appropriate actions
• Excellent verbal and written communication skills
• Strong analytical and problem-solving skills
• Excellent organizational skills and attention to detail
• Excellent time management skills with a proven ability to meet deadlines
• Ability to learn new systems

Requirements

• Logging/tracking all appeals received
• Reviewing appeal and supporting documentation
• Reviewing Summary Plan Documents to determine validity of appeal
• Composing appeal response when necessary
• Communicating with other departments and the clients when necessary
• Documenting the Qiclink system and database with appeal status and outcome
• Coordinating appeal response with business partners
• Prioritize incoming referrals to complete all tasks timely
• Other duties as assigned

Benefits

• Medical, Dental, Vision, Life and Disability Insurance
• Generous Paid Time Off
• Tuition Reimbursement
• EAP
• Technology Stipend

Company Description

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.