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 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.
 
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