Work from home in a focused, behind the scenes role that directly impacts how members experience their health benefits. If you have medical claims appeals experience and you love getting into the details to make sure things are correct and fair, this is your lane.
About Allied Benefit Systems
Allied Benefit Systems is a third party administrator specializing in self funded group health plans. They partner with employers, brokers, and carriers to design, administer, and support customized health benefit solutions. Allied combines strong industry expertise, technology, and service teams to help clients control costs while taking care of their members.
Schedule
- Position type: Full time
- Work setting: Fully remote (home office)
- Hours: Standard business hours, Monday through Friday (exact schedule set by team)
- Environment: Desk based role with extended computer and phone work
- Tech requirement: Reliable home internet via cable or fiber with at least 100 Mbps download / 25 Mbps upload
What You’ll Do
- Monitor and track the status of appeals connected to the Allied Advocate program
- Log and track all appeals received in the internal systems
- Review appeals and supporting documentation to determine appropriateness and completeness
- Read and interpret Summary Plan Documents (SPDs) to evaluate the validity of each appeal
- Draft and compose appeal responses when needed
- Document appeal status, actions, and outcomes in Qiclink and related databases
- Coordinate appeal reviews and responses with internal business partners and external stakeholders
- Communicate with other departments and clients to move appeals toward resolution
- Prioritize incoming referrals and manage workload to meet timelines and quality expectations
- Take on additional related tasks and projects as assigned
What You Need
- Bachelor’s degree or equivalent work experience
- At least 2 years of hands on experience handling medical claims appeals
- Strong working knowledge of medical claims processing
- Proficiency with Microsoft Office Suite or similar software
- Ability to analyze claim situations and choose appropriate actions
- Excellent written and verbal communication skills
- Strong analytical and problem solving skills
- High level of organization, accuracy, and attention to detail
- Proven time management skills with the ability to meet deadlines
- Comfort learning and using new systems and tools
- Ability to sit for long periods and communicate via phone in a remote setting
Benefits
- Pay range: 20 to 21 dollars per hour
- Medical, dental, and vision insurance
- Life and disability insurance
- Generous paid time off
- Tuition reimbursement
- Employee Assistance Program (EAP)
- Technology stipend for remote work setup
- Remote friendly culture with support to help you work effectively from home
If you’re ready to use your medical claims appeals experience in a fully remote role where accuracy and follow through really matter, don’t wait.
Step toward a more flexible work life while still doing meaningful, member focused work.
Happy Hunting,
~Two Chicks…