Appeals Specialist

Allied Benefit Systems

. Organize and complete all claim appeals received in the Appeal Department .

Posted 9/23/2026full-timeRemote • Illinois • United StatesMid-LevelSenior💰 $20 - $21 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing claim appeals, including reviewing documentation, composing responses, and effectively communicating with clients and departments. Proficient in utilizing QicLink for documentation and has a strong background in handling medical, dental, and vision claims.

Highest-signal resume keywords

Claim Appeals ManagementMedical Claims HandlingProficient in ExcelStrong Communication SkillsDocumentation Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claim AppealsMedical ClaimsDental ClaimsVision ClaimsDocumentationAnalysisResponse CompositionQicLink SystemMicrosoft AccessExcel

Soft Skills

Effective CommunicationTimely Task CompletionInterdepartmental Collaboration

Tools & Technologies

QicLinkMicrosoft ExcelMicrosoft WordMicrosoft Access

Industry Keywords

Claim AppealsSummary Plan DocumentsBillingQuality ResultsClient Communication

About the role

Key responsibilities & impact

Organize and complete all claim appeals received in the Appeal Department
Review appeals and supporting documentation
Review Summary Plan Documents to determine appeal validity
Compose appeal response letters when necessary
Communicate with other departments and clients when necessary
Document appeal status and outcomes in the QicLink system and database
Email claims examiners and other units when necessary
Prioritize incoming referrals and complete tasks timely
Perform other related duties as assigned

Requirements

What you’ll need

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
Proficient in Excel and Word
Experience with or ability to learn Microsoft Access
Ability to communicate effectively orally and by email
Ability to analyze claim situations and take appropriate actions
Strong communication and documentation skills
History of excellent quality results
Cable broadband or fiber optic internet service with at least 100Mbps download and 25Mbps upload

Benefits

Comp & perks

Medical insurance
Dental insurance
Vision insurance
Life insurance
Disability insurance
Generous paid time off
Tuition reimbursement
Employee assistance program (EAP)
Technology stipend
Flexible remote work and comfort of working from home