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:25-61151
 
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:

• 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.
• 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 .

Key Requirements and Technology Experience:

• Key Skills:Denials, correspondence or writing, medical office or clerical exp .
• 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. 
• Requires a High School diploma or GED/ Preferred higher education.

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