US
0 suggestions are available, use up and down arrow to navigate them
What job do you want?

Apply to this job.

Think you're the perfect candidate?
Banner of Pyramid Consulting, Inc company

Denial Specialist II

Pyramid Consulting, Inc Tampa, FL (Onsite) Full-Time
Immediate need for a talented Denial Specialist II. This is a 06+months contract opportunity with long-term potential and is located in U.S(Remote). Please review the job description below and contact me ASAP if you are interested.
 
Job ID:25-61076
 
Pay Range: $18 - $19/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:
  • Shift: 10-7 and 11-8pm EST (Typical day will be a 10-7pm or 11-8pm shift est which will include a weekend day, either a Saturday or Sunday and those who work weekends will have the option to work a 10 hr shift. and training will be either 9a-6pm est or 10a-7pm est M-F. 
  • The team works on correspondence for adverse notifications.
  • They mail out documents to members and providers according to state and NCQA guidelines.
  • Some reps work on triaging which would include communications to the medical directors and being a liaison to the care managers and the providers.
  • This is a new request for a new team, new ask, and new role. No additional upcoming hiring needs.
  • This role is pivotal to remaining in compliance with our health plans.
  • The role requires a keen eye and guideline look up per market to ensure we are processing correspondence within contractual timeframes and withing NCQA guidelines.

Key Requirements and Technology Experience:
  • Key Skills:Multitasking ,problem-solving ,Computer savvy .
  • High School diploma    Preferred: Bachelors Degree.
  • 2 years of medical processing or doctor’s office setting experience, clerical background is recommended.
  • previous work in systems like Trucare and Amisys but not required. 
  • Disqualifiers: Short tenure, “job hopping”
  • Performance indicators: 19-23 letters completed per day for correspondence and 40-60 tasks per day for triage. 
  • Best vs. average: Best would be substantial clerical and multitasking abilities.
  • Keen eye for detail. Average would be minimal errors and can produce the performance indicators above.
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.
 
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy .

#prof
J2W:CB3
Get job alerts by email. Join Our Talent Network!

Job Snapshot

Employee Type

Full-Time

Location

Tampa, FL (Onsite)

Job Type

Other

Experience

Not Specified

Date Posted

02/25/2025

Apply to this job.

Think you're the perfect candidate?