Job Title: Denial Specialist II
Contract Type / Duration: 12-Month Contract
Location: Fully Remote
Preferred candidate locations: PST, MST, or CST time zones
(Please note: EST candidates are not preferred due to shift requirements.)
Remote (preferred locations): Missouri, Texas, Illinois, Arizona, California, Kentucky, Ohio, Oklahoma
Work Schedule:
- Saturday & Sunday: 10:00 AM – 7:00 PM EST
- Monday, Thursday & Friday: 1:00 PM – 10:00 PM EST
- Off Tuesday & Wednesday
- Rotating holiday coverage required
Training Schedule:
Monday–Friday, 8:00 AM – 5:00 PM in candidate’s local time zone for approximately 6–8 weeks. No time off permitted during training.
Pay Rate: $23/hour
Position Overview
We are seeking a detail-oriented Denial Specialist II to support healthcare utilization management operations in a fully remote environment. This role is responsible for generating and processing provider and member correspondence related to pre-service and concurrent reviews while ensuring accuracy, compliance, and timely completion of tasks.
The ideal candidate is highly organized, comfortable working independently, and able to manage productivity in a fast-paced remote setting.
Key Responsibilities
- Generate and process denial and approval correspondence based on medical review documentation
- Prioritize escalations, pending denial letters, and compliance deadlines
- Review policy updates and internal communications impacting denial processing
- Maintain productivity and quality standards in a remote work environment
- Utilize systems such as Outlook, Teams, Excel, Word, OneNote, and healthcare correspondence platforms
Top Required Skills
- Strong multitasking, time management, and technical skills
- Ability to adapt quickly, troubleshoot issues, and work independently
- High attention to detail with proficiency in Microsoft Office applications
Preferred Qualifications
- Experience with healthcare denial management systems, claims processing, or appeals tracking
- Understanding of medical terminology and medical record documentation
- Comfortable navigating multiple systems and applications simultaneously
Education Requirements
- High school diploma or equivalent required
- Medical terminology knowledge preferred
Additional Requirements
- Minimum 1 year of relevant healthcare or denial processing experience preferred
- Typing speed of 60 WPM with 95% accuracy required
- Candidates must be comfortable with the required shift schedule and holiday coverage
- No phone-based responsibilities
Interview Process
- Teams video interview (camera on required)
- Typing and computer literacy assessments required
Additional Information
- Candidates must be eligible for W-2 employment
- No Corp-to-Corp (C2C) arrangements
- Candidates must be legally authorized to work in the United States without current or future sponsorship
Equal Opportunity Employer
The client is an Equal Opportunity Employer and considers all qualified applicants without regard to race, color, religion, sex, gender identity, national origin, disability, age, veteran status, sexual orientation, or any other protected status under applicable law.