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:25-94852

Pay Range: $21 - $22.47/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:

• Independent work, flexible, prioritize deadlines (must action on denials as soon as it’s presented)
• Work based on turn around time – depends on line of business
• Inpatient 24-28 hours vs outpatient 3-5 days turn around
• Won’t be working directly with members or providers
• Quick and accurate work
• performance expectations/metrics – 4 letters completed per hour
• Applications – Trucare, Faxing, Excel, word, outlook, teams, one drive, one note
• 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
• Complies with all policies and standards

Key Requirements and Technology Experience:

• Advanced Computer Skills, multitasking skills – in different systems at once, independent work
• Proficient in Written English Language
• Previous denial, appeals, UM experience a plus
• Years of experience required: 1-2 years related experience (basic knowledge of medical terminology), CNA, CMA, denials.
• Previous denial, appeals, UM experience a major plus.
• Required Testing or Assessment:-Please perform computer literacy test and Typing Test T,yping Test (35 WPM with 90% accuracy)
• Applications worked in most Excel, word, outlook, teams, one drive, one note
• Typing test – less concerned about the speed, just need accuracy and punctuation (90% and up)

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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