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Appeals Specialist
Location:
Anderson, IN
Description:
Unified Group Services is a full-service third-party administrator (TPA) for self-insured group health plans. We're dedicated to providing excellent customer service and the flexibility our customers desire in administering employee benefit plans. Unified Group Services has a reputation for excellent customer service in the marketplace, and this position is crucial to continuing that status. 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. JOB QUALIFICATIONS: 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. PAY BASIS: Hourly Hours are Monday through Friday, 8:00 a.m. to 5:00 p.m. BENEFITS: Unified Group offers an excellent benefits package including: 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. OTHER REASONS TO WORK HERE: Family-oriented, positive work environment Weekends off Voluntary overtime during peak season Recently voted one of the Best Places to Work in Indiana! This is an in-the-office position. We are located just off I-69, exit 226. Unified Group Services is an Equal Opportunity Employer.
Company:
Unified Group Services
Posted:
April 25 on ApplicantPRO
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More About this Listing: Appeals Specialist
Appeals Specialist is a Production Appeals Specialist Job at Unified Group Services located in Anderson IN. Find other listings like Appeals Specialist by searching Oodle for Production Appeals Specialist Jobs.
Appeals Specialist is a Production Appeals Specialist Job at Unified Group Services located in Anderson IN. Find other listings like Appeals Specialist by searching Oodle for Production Appeals Specialist Jobs.