Use your eye for detail and knowledge of medical claims to help members get fair decisions while working from home. This remote Appeals Specialist role is ideal if you like digging into documentation, interpreting plan rules, and seeing complex issues through to resolution.
About Allied Benefit Systems
Allied Benefit Systems is a Chicago-based third-party administrator that designs and manages self-funded group health plans for employers nationwide. They support employers with flexible benefit options, claims administration, and member services. As part of the Claims team, you’ll sit right where members, employers, and carriers intersect, helping resolve appeals accurately and on time.
Schedule
- Full-time, fully remote position
- Standard office hours in a computer-based environment
- Must have reliable high-speed internet (cable or fiber) with at least 100 Mbps download / 25 Mbps upload
What You’ll Do
- Log, track, and monitor all appeals received under the Allied Advocate program
- Review appeal requests and supporting documentation for completeness and appropriateness
- Read and interpret Summary Plan Documents to determine whether an appeal is valid under plan rules
- Draft appeal responses when needed, clearly summarizing findings and outcomes
- Document appeal status and outcomes in the Qiclink system and internal databases
- Coordinate with internal business partners and external clients to gather details and finalize responses
- Communicate updates to other departments and clients as needed
- Prioritize incoming referrals so all tasks and timelines are met
- Handle additional appeals and claims-related duties as assigned
What You Need
- Bachelor’s degree or equivalent work experience
- At least 2 years of hands-on experience handling medical claims appeals
- Strong knowledge of medical claims processing and how appeals flow through a plan
- Proficiency with Microsoft Office or similar software
- Ability to analyze claim situations, interpret documentation, and take appropriate action
- Strong written and verbal communication skills
- Solid analytical, problem-solving, and decision-making skills
- High attention to detail, organization, and documentation accuracy
- Proven time-management skills and comfort working with deadlines
- Ability to learn new systems and tools
Benefits
- Hourly pay typically in the 20 to 21 dollars per hour range, depending on experience
- Medical, dental, and vision insurance
- Life and disability coverage
- Generous paid time off
- 401(k) with company match
- Tuition reimbursement
- Employee Assistance Program (EAP)
- Technology stipend to support remote work
- Remote-friendly culture with room to grow
Appeals work moves fast and impacts real people – if you like being the calm, precise voice in the middle of complex claims, this is a strong next step.
Take the next move toward a stable, fully remote role with growth potential.
Happy Hunting,
~Two Chicks…