Claims Specialist

Pyramid Consulting, Inc; United States; Remote; USD 30,000 - 32,000; Full time

Benefits offered by this job

Health insurance

401(k) plan

Paid sick leave

Job summary

Pyramid Consulting, Inc. is seeking a detail-oriented healthcare claims processor for a 6+ month contract offering remote work in the United States.

The role focuses on reviewing appeals, disputes, and reconsiderations, with emphasis on accurate data entry at 40 WPM and adherence to regulatory guidelines. The ideal candidate has 2+ years in healthcare claims processing, familiarity with TruCare and AMISYS, and a High School diploma or GED.

Qualifications

• 2+ years of healthcare claims processing experience including claims review, denials, or reconsiderations.
• Strong data entry skills at 40 WPM with 90% accuracy.
• Experience with TruCare and AMISYS preferred.
• High School diploma or GED required.
• Knowledge of appeals, disputes, and reconsiderations processes.
• Experience in Claims Processing, Utilization Management, and Medical Billing/Coding.

Responsibilities

• Review and process appeals, disputes, and reconsiderations following regulatory guidelines.
• Perform data entry to track, log, and process appeals with 40 WPM and high accuracy.
• Prepare correspondence and maintain documentation related to appeals and disputes.
• Conduct research to evaluate and respond to claims for timely decisions.
• Gather data to track trends and outcomes, and perform outreach for updates as needed.
• Comply with all policies and standards while performing other duties.

Skills

Healthcare claims processing

Data entry (40 WPM)

TruCare AMISYS experience

Education

High School diploma or GED

Tools

TruCare

AMISYS

Job description

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).

06+ Months Contract

US (Remote)

Key Responsibilities:

• Support the team in reviewing and processing appeals, disputes, and reconsiderations in accordance with established regulatory and accreditation guidelines.
• Perform data entry to track, log, and process appeals with a focus on accuracy (40 WPM, 90% accuracy).
• Prepare correspondence and maintain documentation files related to appeals and disputes.
• Conduct research to evaluate and respond to claims effectively, ensuring timely decisions.
• Gather data to track trends and final outcomes, conducting outreach for updates as necessary.
• Comply with all policies and standards while performing other duties as assigned.

Key Requirements and Technology Experience:

• 2+ years of healthcare claims and authorization experience, including claims review, provider appeals, denials, or reconsiderations.
• Strong data entry skills (40 WPM, 90% accuracy) and attention to detail.
• Experience with TruCare and AMISYS preferred.
• High School diploma or GED [Required].
• Knowledge of appeals, disputes, and reconsiderations processes.
• Experience in Claims Processing, Utilization Management, and Medical Billing/Coding.

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions.

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, color, 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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