Appeals Specialist
Job Posting for Appeals Specialist at Unified Group Services
Appeals may be submitted by providers and/or their representatives, members, attorneys, and sometimes a PPO (Preferred Provider Organization) may request a review. JOB DESCRIPTION:
- Research internal/external appeal (benefit determination, Usual and customary reduction, discount dispute, eligibility).
- Work with internal review vendors on internal appeals and independent review organizations (IRO) on external reviews. This essential team review requires the employee to work inside the office.
- Work with our clients, reinsurance department, subrogation department, case management/pre-cert vendors, PPOs on occasion
- Draft letters in response to appeal (providers, provider representatives, members, occasionally an attorney)
- Adhere to plan timeframes regarding all aspects of appeals
- As with any job, there may be other tasks assigned as necessary.
- High School Diploma or GED. Some college is helpful but not required
- Working knowledge of Microsoft Word, Excel, and Outlook is required
- Strong math skills.
- Attention to detail and the ability to meet deadlines are critical to success.
- Professional phone communication skills.
- Good organizational skills and excellent customer service.
- Good writing skills, using proper grammar, punctuation, and sentence structure.
- Problem-solving and decision-making skills are vital
- Self-motivated & self-starter with a willingness to learn.
- Excellent attendance.
- Medical, dental, and vision insurance
- Matching 401K plan
- Life insurance
- Short and Long-term disability
- Student loan debt payments
- Vacation and PTO time
- Health Clinic
- Sponsored wellness plans.
- Family-oriented, positive work environment
- Weekends off
- Voluntary overtime during peak season
- Recently voted one of the Best Places to Work in Indiana!
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Job openings at Unified Group Services
Unified Group Services
Anderson, IN
Full Time
Unified Group Services
Anderson, IN
Full Time
Unified Group Services
Anderson, IN
Full Time
Unified Group Services
Anderson, IN
Full Time
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