Denial Specialist

Immediate need for a talented Denial Specialist  . This is a 03 months Contract to Hire opportunity with long-term potential and is located in TX(Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID: 25-87705

Pay Range: $22 - $23/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 timing: 12pm – 9pm CST
• Generates, processes and maintains provider and member correspondence for preservice and concurrent review.
• Maintain the denial logs in accordance with associated guidelines
• Responsible for the Medical Management denial process including letter printing, tracking and disposition of letters within contractual guidelines to ensure compliance
• Serve as the department liaison for all denial issues
• Train others on denial work processes
• Review monthly, quarterly, and annual reports for denials
• Review log to ensure compliance with the denial process and turn-around timeframe (TAT) for all denial and/or appeals notifications
• 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; Understanding medical terminology
• 40 WPM
• Requires 1 – 2 years of related experience.
• Requires a High School diploma or GED

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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