Remote Appeals Coordinator (No Surprise Act)

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    "jobTitle": "Remote Appeals Coordinator (No Surprise Act) ",
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    "description": "<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">POSITION SUMMARY: </span></span></b></span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"background:#FFFFFF;\"><span style=\"font-family:Arial, sans-serif;\"><span style=\"color:#000000;\">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 and routing documentation to business partners for review/resolution.  The Appeals Specialist also provides follow up with business partners on aging appeals. The Appeals Specialist requires a strong knowledge of medical claims processing. This position also coordinates with Allied business partners for documenting and tracking appeals.</span></span></span></span></span></span></p>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">ESSENTIAL FUNCTIONS: </span></span></b></span></span></span></p>\n\n<ul>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Logging/tracking all appeals received</span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Reviewing appeal and supporting documentation</span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Reviewing Summary Plan Documents to determine validity of appeal</span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Composing appeal response when necessary</span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Communicating with other departments and the clients when necessary</span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Documenting the Qiclink system and database with appeal status and outcome</span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Coordinating appeal response with business partners</span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Prioritize incoming referrals to complete all tasks timely   </span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Other duties as assigned</span></span></span></span></span></li>\n</ul>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">EDUCATION: </span></span></b></span></span></span></p>\n\n<ul>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><em><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Bachelor’s degree or equivalent work experience required.</span></span></em></span></span></li>\n</ul>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">EXPERIENCE AND SKILLS:</span></span></b></span></span></span></p>\n\n<ul>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><em><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">2 years of comprehensive experience with the handling of medical claims appeals experience required.</span></span></em></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span><span><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><em><span style=\"font-family:Arial, sans-serif;\">Proficient with Microsoft Office Suite or related software required.</span></em></span></span></span></span></span></li>\n\t<li style=\"margin-bottom:11px;margin-left:8px;\"><span style=\"font-size:11pt;\"><span><span><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><em><span style=\"font-family:Arial, sans-serif;\">Ability to analyze claim situations and take appropriate actions.</span></em></span></span></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><em><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Excellent verbal and written communication skills.</span></span></em></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><em><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Strong analytical and problem-solving skills.</span></span></em></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><em><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Excellent organizational skills and attention to detail.</span></span></em></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><em><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Excellent time management skills with a proven ability to meet deadlines.</span></span></em></span></span></span></li>\n\t<li><span style=\"font-size:12pt;\"><span><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">Ability to learn new systems.</span></span></span></span></span></li>\n</ul>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">POSITION COMPETENCIES:</span></span></b></span></span></p>\n\n<ul>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\"><span style=\"color:#000000;\">Accountability</span></span></span></span></span></li>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:11pt;\"><span style=\"line-height:107%;\"><span style=\"font-family:Calibri, sans-serif;\"><span style=\"font-family:Arial, sans-serif;\"><span style=\"color:#000000;\">Communication</span></span></span></span></span></li>\n\t<li 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style=\"font-family:Arial, sans-serif;\">WORK ENVIRONMENT:</span></span></b></span></span></span></p>\n\n<ul>\n\t<li style=\"margin-left:8px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\"><span style=\"color:#000000;\">Remote</span></span></span></span></span></li>\n</ul>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:10.5pt;\"><span style=\"font-family:Arial, sans-serif;\">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</span></span><span style=\"font-size:10.5pt;\"><span style=\"font-family:Calibri, sans-serif;\">.</span></span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:10.5pt;\"><span style=\"font-family:Arial, sans-serif;\">The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.</span></span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:10.5pt;\"><span style=\"font-family:Arial, sans-serif;\">Compensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.</span></span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:10.5pt;\"><span style=\"font-family:Arial, sans-serif;\">Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.</span></span></span></span></p>",
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