Denial Specialist II

Immediate need for a talented Denial Specialist II. This is a 06+months contract opportunity with long-term potential and is located in USA(Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID: 25-85569

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:

• Training: 9am-6pm est – 4 weeks – NO TIME OFF – DAY ON CAMERA ON
• Working Hours: M-F 2pm – 11pm Eastern.
• This dept is open 365 days a year. Weekends/Holidays and OT are required on a rotation and/or volunteer basis
• The team works from queues where tasks are either assigned to or pulled by the team member.
• The letters are created using a template. MD rationales will be reviewed, and easily readable descriptions are added, when necessary, for NCQA compliance.
• The quality goal is 95% or greater each month and the production is weighted by type of letter. A weekly and monthly average of 100% meets the goal.
• The team works from queues where tasks are either assigned to or pulled by the team member.
• The letters are created using a template.
• MD rationales will be reviewed, and easily readable descriptions are added, when necessary, for NCQA compliance.
• The quality goal is 95% or greater each month and the production is weighted by type of letter. A weekly and monthly average of 100% meets the goal.

Key Requirements and Technology Experience: 

• Key Skills; Claim Denial
• correspondence letters
• Denial Letters
• Claim Processing
• Healthcare
• strong knowledge of medical terminology
• strong writing and communication skills
• Complies with all policies and standards
• data entry within excels.
• Strong knowledge of medical terminology
• Strong written communication skills
• Strong computer skills with ability to navigate quickly (data entry/trucare/excel)
• Requires a High School diploma or GED

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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