Remote Denial Specialist

Saint Louis, MI - USA

Monthly Salary: Not Disclosed

Posted on: 8 hours ago

Vacancies: 1 Vacancy

Job Summary

Job Title: Denials Specialist (Remote)

Pay Rate: $22.47/hour
Assignment Length: 6-12 months (with potential to extend or convert)

Shifts Available:

Shift 1: 1 -10 pm CST Tuesday-Saturday. Training required during standard business hours.

Shift 2: 8-5pm CST Tuesday - Saturday. Training required during standard business hours.

Shift 3: 1-10 pm CST Sunday-Thursday. Training required during standard business hours.

Shift 4: 8-5pm CST Monday-Friday. Training required during standard business hours.

Shift 5: 8-5pm CST Sunday-Thursday. Training required during standard business hours.

Position Overview

This role is responsible for generating processing and maintaining provider and member correspondence related to preservice and concurrent reviews. The position supports denial communications by accurately producing letters from medical documentation while meeting regulatory timelines and quality standards.

This is a non-member-facing independent role that requires strong attention to detail written communication skills and comfort working across multiple systems.

Key Responsibilities

Generate and process denial and authorization correspondence using EMR documentation
Ensure all correspondence is completed accurately and within required turnaround times
Maintain and update correspondence templates based on regulatory and internal requirements
Support data tracking and reporting related to the denial process
Assist with monitoring correspondence turnaround times
Perform additional administrative tasks as assigned

Performance Expectations

Complete an average of 4 letters per hour
Maintain 95% accuracy including grammar and punctuation
Meet turnaround time requirements based on line of business
Work independently while prioritizing time-sensitive tasks

Required Qualifications

High School Diploma or GED
1 2 years of related healthcare or administrative experience
Strong written English skills (accuracy and punctuation are critical)
Basic knowledge of medical terminology
Advanced computer skills and ability to work in multiple systems simultaneously

Preferred Qualifications

Experience with denials appeals or utilization management
Background as a CNA CMA Radiology Tech Sonography Tech or Coding Certification
Familiarity with EMR systems and medical documentation

Tools & Systems Used

TruCare
Microsoft Excel Word Outlook Teams
OneDrive and OneNote
Faxing and document management tools

Additional Notes

Role does not involve direct interaction with members or providers
Typing accuracy of 90% or higher is required (speed is less important than accuracy)
Candidates with only call center experience may not be a fit

CLIENT does not discriminate in employment on the basis of race color religion sex (including pregnancy and gender identity) national origin political affiliation sexual orientation marital status disability genetic information age membership in an employee organization retaliation parental status military service or other non-merit factor.

Job Title: Denials Specialist (Remote) Pay Rate: $22.47/hour Assignment Length: 6-12 months (with potential to extend or convert) Shifts Available: Shift 1: 1 -10 pm CST Tuesday-Saturday. Training required during standard business hours. Shift 2: 8-5pm CST Tuesday - Saturday. Training required d...