Senior Claims Adjustment Analyst (Remote)

POSITION SUMMARY

The Senior RRT Analyst will be responsible for reviewing the incoming referrals daily to determine priority and distribute team assignments.  The Senior Analyst will run reports from Allied’s website for special projects that are received within the department to determine adjustments needed and assign accordingly.  Provide training to the team as needed. The Senior RRT Analyst will also be responsible for managing Blue Cross Blue Shield (BCBS) and Anthem adjustments. 

ESSENTIAL FUNCTIONS

• Work with other departments when necessary to determine appropriateness of an RRT referral.
• Manage the BCBS and Anthem process, including adjustments and closing claims in the BCBS systems.
• Tracking and handling of projects timely
• Update member accumulators and complete adjustments as necessary
• Maintain department workflows for RRT processes
• Handle tasks assigned to RRT such as high dollar split claims, repricing adjustments, and group exception referrals
• Run web reports for special projects
• Support other units within Claim Operations
• Support Refund process when needed
• Other related duties as assigned

EDUCATION

• High school diploma or equivalent required

EXPERIENCE AND SKILLS

• Applicants must have 5+ years of comprehensive experience with adjustment processing
• Applicant must be proficient at the use of Microsoft Word and Excel programs and can easily learn other data systems.

POSITION COMPETENCIES

• Accountability
• Analytical Thinking
• Collaboration
• Communication
• Customer Focus
• Functional Expertise
• Initiative

PHYSICAL DEMANDS

• This is a standard desk role that requires extended periods of sitting and computer work

WORK ENVIRONMENT

• Remote

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.

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.

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.

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.