Allied Benefit Systems · 19 hours ago

Appeals Analyst

United States

Full-time

Remote

Entry, Mid Level

2+ years exp

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Responsibilities

Independently review and analyze appeals related to Allied’s Cost Containment programs.

Review Summary Plan Documents to determine validity of appeals.

Review, analyze and add applicable notes to the QicLink System.

Review/audit processed health care claims for accuracy.

Consult with other entities who can offer additional review of an appeal.

Respond timely and appropriately to inquiries related to the No Surprises Act, including Independent Dispute Resolution (IDR) and open negotiation requests.

Other duties as assigned.

Qualification

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ICD Codes KnowledgeCPT Codes KnowledgeMicrosoft OfficeExcelPower PointHealthcare Claims AnalysisProblem-Solving Communication Analytical Skills Organizational SkillsTime ManagementCollege DegreesAdvanced Degrees