Appeals Specialist I

Posted 11 Hours Ago
Be an Early Applicant
Pinecrest, FL
Entry level
Insurance
The Role
The Appeals Specialist I processes and coordinates appeals related to health insurance, ensuring compliance with federal and state regulations. Responsibilities include responding to inquiries, managing case details, and entering information into databases, with a requirement for some travel.
Summary Generated by Built In

At Dearborn, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

Under Supervision, This Position Is Responsible For Processing, Organizing, And Coordinating All Materials And Information Relating To Processing Appeals For All Lines Of Business Following Federal, State, And Accreditation Requirements; And For Accurately Responding By Telephone, In Person, Or Through Correspondence To All Inquiries Involving Requests For Appeals From Members, The Department Of Labor, Or Erisa, Providers, Or A Member Authorized Representative; Sending Letters And Updates According To The Case Requirements; And Entry Of Appeals Into The Appropriate Database. Ability To Travel, Including Overnight Stays.

JOB REQUIREMENTS:
* High School Degree or GED.
* 1 year experience in a customer service role in a health insurance or medical environment
* Analytical, problem solving and research skills.
* Organizational skills to accommodate large volume of reference materials combined with time management skills to achieve accessibility to callers.
* Verbal and written communication skills to clearly express oneself in a well-modulated tone with correct grammar and attention to enunciation.
* Experience working both independently and in a team environment to meet deadlines according to regulations
* Ability to travel, including overnight stays
PREFERRED JOB REQUIREMENTS:
* BlueChip claims payment experience.
* Medical terminology.
* Knowledge of appeals processing.
* Ability to think clearly and maintain a professional, poised attitude under pressure.
* Detail oriented.
* Bi-lingual Spanish speaking.


Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Dearborn, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, a minimum of 15 days’ of paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for full-time employees

The salary offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Dearborn Group Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range$17.20 - $27.15

The Company
HQ: Lombard, IL
308 Employees
On-site Workplace

What We Do

Dearborn Group is the trade name for Dearborn Life Insurance Company. Since 1969, we have been providing ancillary benefits to employer groups across the country.

When combined with medical coverage, our suite of employer-paid and voluntary insurance solutions—life, short- and long-term disability, vision, critical illness and accident insurance—creates a comprehensive benefits package and gives employers, their employees, and their families complete peace of mind.

Dearborn Group insurance products are issued by Dearborn Life Insurance Company, 701 E. 22nd St. Suite 300, Lombard, IL 60148.

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