Administrative Assistant – Appeals Specialist

About the role

The Appeals Specialist supports the Appeals Team by managing individual client cases through the appeals process. The role ensures high‑quality submissions, timely follow‑ups, and accurate data entry within Guided Care software to achieve positive outcomes for clients.

Key responsibilities

• Process assigned client appeal cases, meeting defined turn‑around times.
• Ensure each appeal meets quality, compliance, and clinical standards set by Guided Care.
• Maintain accurate, complete, and up‑to‑date client data in Guided Care software.
• Participate in workflow improvements and quality initiatives.
• Communicate promptly and respectfully with colleagues and leadership.
• Attend training sessions, team meetings, and incorporate feedback.
• Uphold company core principles (GUIDE) in all interactions.
• Maintain excellent attendance and perform additional duties as assigned.

Required profile

• Minimum 3 years of experience in a healthcare environment.
• Independent, self‑motivated, detail‑oriented with strong research and organizational abilities.
• Excellent time‑management skills and ability to meet deadlines.
• Strong collaborative mindset and ability to build positive relationships.
• Clear communication skills and ability to convey information effectively.
• Discretion, sensitivity, and strict confidentiality.
• Professional video‑meeting setup (quality camera) and focus during calls.
• Punctuality and professional representation in virtual meetings.

Required skills

• Microsoft Office proficiency.
• Experience with Zoom video conferencing.
• Experience with Microsoft Teams.
• Familiarity with Guided Care software for case management.