Denial Specialist II

Immediate need for a talented Denial Specialist II. This is a 04+ 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: 25-66389
 
Pay Range: $16 - $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: 10-7pm 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 9am-6pm EST or 10am-7pm EST (M-F)
• As a part of our hiring process, along with an option to directly connect with a Recruiter, we now offer a texting option to enhance your candidate experience. 
• Click the link below which contains a few basic questions that will help you ensure this is a good fit and expedite the shortlisting process :
  https://hire.glider.ai/connect/16067205
• 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.
• Typical task and breakdown would be 10% meetings 70% correspondence writing, 10% collaborations and 10% other tasks
• 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; CLAIMS CORRESPONDENCE , HEALTHCARE CLAIM REVIEW , CLAIM DENIAL MANAGEMENT, HEALTHCARE CLAIM DENIAL.
• 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.
• 19-23 letters completed per day for correspondence and 40-60 tasks per day for triage.
• Required: High School diploma / Bachelors Degree (Preferred)
• 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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