Immediate need for a talented
Denial Specialist II. This is a
06+months contract opportunity with long-term potential and is located in
Oregon,OR /Washington(Remote). Please review the job description below and contact me ASAP if you are interested.
Job ID:24-43990
Pay Range: $21 - $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:
- Process member/provider approval and denial letters.
- 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 standard.
- Production driven environment - applies to TAT regulations / state - maintains quality standard of 95% - meets production average standard of 28 denials per a day or 40 approvals per a day.
- Knowledge of denials process including understanding medical record information preferred.
Key Requirements and Technology Experience:
- Key Skills: Approvals, denials, healthcare exp, medical records exp.
- 1-2 years of experience with approvals and denials.
- Healthcare exp-medical records exp.
- Strong computer skills, and ability to work in production-based role.
- Begin onboarding process / Complete compliance courses / shadowing a peer to see what the job will entail.
- What previous job titles or background work well in this role?
- Working in a healthcare environment or for managed care operations, strong written skills, medical terminology knowledge, Insurance experience preferred.
- What makes your team/department/culture special that you would like candidates to know?.
- High moral - everyone collaborates to ensure TAT is met - great attitudes - extremely low overturn.
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.
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