Denial Specialist II

Pyramid Consulting, Inc; United States; Remote; USD 30,307 - 31,684; Full time

Benefits offered by this job

Health insurance (medical, dental, vision)

401(k) plan

Paid sick leave

Job summary

A leading healthcare consulting firm is seeking a Denial Specialist II for a remote contract position. This role involves writing and managing correspondence letters to providers and members, ensuring adherence to quality goals. Candidates should possess strong communication skills, knowledge of medical terminology, and experience in the healthcare industry. A minimum typing speed of 60WPM with high accuracy is required. The position offers competitive pay and requires efficient handling of denials and approvals.

Qualifications

• Experience in the healthcare industry is essential.
• Ability to write clearly and effectively for communication purposes.
• Familiarity with denial and approval processes in healthcare.

Responsibilities

• Write and send correspondence letters to providers and members.
• Ensure quality goals of 95% or greater each month.
• Minimum of 40 denials/approvals processed in an 8-hour day.

Skills

Health care industry experience

Strong writing and communication skills

Fast typing speed (60WPM with 90% accuracy)

Strong knowledge of medical terminology

Data entry within Excel

Tools

Excel

Word

Outlook

Teams

One Drive

One Note

True Care

Job description

Pyramid Consulting, Inc. Pay Range

This range is provided by Pyramid Consulting, Inc. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base Pay Range

$22.00/hr - $23.00/hr

Immediate need for a talented Denial Specialist II. This is a 12 Months Contract opportunity with long-term potential and is US Remote. Please review the job description below and contact me ASAP if you are interested.

Job Diva ID: 25-94913

Pay Range: $22.00 - $23.00/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

• We write and send correspondence letters to providers and members (in easily readable language), ensuring that they are sent within the contractual turnaround time.
• It’s a remote position and the whole team works remotely.
• The team works from queues where tasks are either assigned to or pulled by the team member.
• The letters are created using a template.
• MD rationales will be reviewed, and easily readable descriptions are added, when necessary, for NCQA compliance.
• The quality goal is 95% or greater each month and the production is weighted by type of letter. A weekly and monthly average of 100% meets the goal.
• Denials/Approvals – min of 40 in 8 hour day
• Applications - excel, word, outlook, teams, one drive, one note, true care

Key Requirements and Technology Experience

• Health care industry experience, strong knowledge of medical terminology, strong writing and communication skills, complies with all policies and standards, data entry within excel.
• Fast typing Speed (60WPM with 90% Accuracy)
• Knowledge of denials/approvals process

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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