Medical Data Entry Clerk- FULLY REMOTE

TEKsystems, Inc.; Orlando (FL); Remote; USD 41,000 - 52,000; Full time

Job summary

A leading company in technology and talent services is seeking a fully remote Medical Data Entry Specialist. The role involves managing appeals and grievances in healthcare, ensuring compliance, and requires strong analytical and communication skills. Ideal candidates will have at least 3 years of relevant experience. The position offers a pay rate of $20.00/hr along with several benefits depending on eligibility.

Benefits

Medical insurance

Dental insurance

Vision insurance

401(k)

Life insurance

Disability income insurance

Health savings account (HSA)

Employee assistance program

Paid time off

Qualifications

• At least 3 years of related professional experience, preferably in health industry.
• Excellent verbal and written communication skills.
• Experience in managed care or compliance environments.

Responsibilities

• Managing a backlog of 10,000 appeals and grievances.
• Processing appeals and grievances to ensure compliance.
• Responding to complaints and maintaining relations with members and providers.

Skills

Communication

Problem Solving

Analytical Skills

Organizational Skills

Time Management

Tools

MS Office

Job description

TekSystems is currently hiring for a FULLY REMOTE Medical Data Entry Specialist!

MUST HAVE: Must be on EST time zone, and have experience in healthcare administrative work, medical billing, claims, grievances, appeals, or related fields.

Description

This is a remote position with a shift from Monday to Friday, 9am - 5pm EST.

Position Overview:

The role involves managing a backlog of 10,000 appeals and grievances, filtering through appeals, and taking appropriate actions.

Responsibilities include:

• Responding to written and verbal grievances, complaints, appeals, and disputes in accordance with NCQA, CMS, State, and other regulations.
• Processing appeals and grievances to ensure benefits and clinical policies are administered accurately and in compliance with all regulatory standards.
• Serving as an effective interface between internal teams and external customers, maintaining good relations with members and providers.
• Reviewing and evaluating appeal and grievance requests to classify and determine eligibility, benefits, and prior activities.
• Providing written acknowledgment and making verbal contact with members or their representatives during investigations.
• Conducting thorough investigations, analyzing issues, and obtaining responses from relevant entities.
• Collaborating with departments and external entities to resolve cases timely.
• Preparing cases for medical and administrative review, ensuring documentation is complete and accurate.
• Monitoring pending reports and worklists to meet internal and regulatory timeframes.
• Monitoring outcomes of appeals and identifying areas for improvement, providing feedback to management.
• Responding to member and provider correspondence with accurate and structured communication.

Additional Skills & Qualifications:

• At least 3 years of related professional experience, preferably in health industry or compliance.
• Excellent verbal and written communication skills.
• Experience in managed care or compliance environments.
• Proficiency in MS Office applications.
• Strong problem-solving, analytical, organizational, and time management skills.

Pay and Benefits:

The pay rate is $20.00/hr. Benefits may include medical, dental, vision, 401(k), life insurance, disability, HSA, transportation, employee assistance, and paid time off, depending on eligibility.

Workplace Type: Fully remote.

Application Deadline: July 10, 2025.

About TEKsystems:

TEKsystems is a leader in technology and talent services, serving over 6,000 clients globally, including 80% of the Fortune 500. We are committed to diversity and equal opportunity employment.