Sr. Appeals Support Specialist

3 months ago

Oak Brook, United States Inspira Financial Full time

Take the next step in your journey at Inspira Financial. You will help businesses and individuals thrive today, tomorrow, and into retirement. Become part of a company that is people centric and client obsessed in every interaction; a community of forward-thinking individuals focused on driving results to deliver our mission with an unwavering commitment to integrity. Join us as we strengthen and simplify the health and wealth journey - relentlessly pursuing better outcomes for all. We believe in finding the best talent While some roles are based at one of our office locations, remote roles can sit in any of the following states: AL, AZ, FL, GA, IA, IL, IN, MI, MN, MO, NC, NE, PA, SC, TN, TX, UT, VA and WV. Remote status and role locations are subject to change. Relocation is not provided.
Don't meet every single requirement? Here at Inspira Financial, we believe there is no "perfect" candidate and want to encourage applying even if all the requirements listed aren't met. Our goal is to build an authentic workplace by valuing diversity in our candidates. We work to ensure that our team reflects the diversity of the businesses and clients we serve. We are always looking to expand our growing team with dynamic and enthusiastic individuals. If you enjoy a collaborative, fun environment that champions career development, Inspira Financial is the place for you We look forward to receiving your application Check out this Inspira Financial video to learn more about our company
HOW YOU WILL SOAR:
The Sr. Appeals Support Specialist will report to the Manager of Appeals in the H&B Claims Operations department. This role is responsible for the research, analysis, and completion of complex accountholder appeal investigations. Consistently administering the thorough and fair review of appeal requests in a timely manner.

  • Effectively process appeals for all claim types and solve complex account transactions for accountholders
  • Review and resolve substantiations, card activations, and escalated issues
  • Make outbound calls to accountholders and/or providers as necessary to resolve claim appeal issues
  • Identify and understand application of fund reallocation, carryover, and rollback
  • Overpayment account reviews and Grace period adjustments from one plan year to another
  • Assist account managers with reallocating, payment adjustments, and claim denials as needed
  • Other duties as assigned


IF YOU HAVE SOME OR ALL OF THE FOLLOWING, APPLY:

  • 3-5+ years of experience processing claim appeals
  • Processing claims and appeals for FSA, DCFSA, HRA, WRA, and LSA's
  • Solid experience with ERISA, HIPAA, 213d, 503c and IRS Regulations
  • 2+ years of experience processing claims
  • Detail-oriented, organized, and dependable
  • Possess a strong aptitude for numbers and reconciliations
  • Strong problem-solver and solution proposer; that is proactive and analytical
  • Operate efficiently, with a high degree of accuracy and follow-through
  • Proven ability to both prioritize and manage multiple tasks to completion
  • Ability to work effectively and accurately under pressure
  • Possess excellent verbal and written communication skills
  • Operate with a high sense of responsibility and conscientiousness in delivering results
  • Optimistic with a consistently positive and flexible attitude
  • Demonstrated strong aptitude and proficiency with Microsoft Excel, Word, Outlook, and Teams
  • Ability to maintain the highest quality of service


Inspira Financial provides health, wealth, retirement, and benefits solutions that strengthen and simplify the health and wealth journey. With more than 7 million clients, representing over $62 billion in assets, Inspira works with thousands of employers, plan sponsors, recordkeepers, TPAs, and other institutional partners - helping the people they care about plan, save, and invest for a brighter future. Inspira relentlessly pursues better outcomes for all with our automatic rollover services, health savings accounts, emergency savings funds, custody services, and more. Learn more at inspirafinancial.com.
We have been recognized for our remarkable growth on lists such as Crain's Fast 50 and Inc. 5000, and for our outstanding workplace culture and benefits with Built In's 2023 Best Places to Work and Gallagher's 2022 Best-In-Class Employer awards.

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