Denial Specialist II

Immediate need for a talented Denial Specialist II . This is a 12 months contract opportunity with long-term potential and is located in U.S(Onsite). Please review the job description below and contact me ASAP if you are interested.

Job ID:25-94914

Pay Range: $22 - $23/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• Generates, processes, and maintains provider and member correspondence for preservice and concurrent review
• Review faxes and process them into electronic medical record system
• Complete 25-35 phone calls a day
• Fax Denials letters to provider

• Knowledge of denials process including understanding medical record information preferred.
• Generates correspondence from EMR documentation and ensures correspondence tasks are processed in a timely manner to ensure compliance according to regulatory standards and policies
• Updates and maintains correspondence templates based on regulatory, and interdepartmental correspondence inquiries
• Coordinates all data collection, analysis, and reporting activities that impact the denial process
• Assists with the compliance and turn-around time (TAT) log for all correspondence notifications
• Performs other duties as assigned
• Complies with all policies and standards

Key Requirements and Technology Experience:

• Key Skills; Computer skills
• Customer service
• Medical terminology
• HCPS/CPT coding
• Requires a High School diploma or GED
• Requires 1 – 2 years of related experience

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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