BC Forward is looking for Denial Specialist II - 100% Remote
Position: Denial Specialist II
Location: 100% Remote
Duration: 12 months of contract with extension and contract to hire
Shift: Sunday- Thursday 1pm - 10pm CST
Pay Rate: $23.00/hr
Required: Must pass a computer competency test and achieve 60 WPM typing speed with at least 90% accuracy.
Position Purpose:
The Denial Specialist is responsible for generating, processing, and maintaining provider and member correspondence for preservice and concurrent reviews. This includes ensuring correspondence is processed in a timely manner, compliant with regulatory standards and internal policies.
Key Responsibilities:
Generate correspondence from EMR (electronic medical record) documentation, ensuring timely processing and compliance with regulatory and organizational standards. Update and maintain correspondence templates based on regulatory requirements and internal department inquiries. Coordinate all data collection, analysis, and reporting activities that impact the denial process. Assist with maintaining the compliance and turnaround time (TAT) log for all correspondence notifications. Perform other duties as assigned. Ensure compliance with all policies and standards.
Education/Experience Requirements:
High school diploma or GED. 1-2 years of related experience preferred. Knowledge of the denials process and medical record information is a plus.
Skills Required:
Computer skills, including proficiency with Microsoft Office and Teams. Customer service experience. Medical terminology knowledge.
Preferred Skills:
HCPCS/CPT coding knowledge.
Additional Requirements:
Typing speed of 60 words per minute (minimum). Must pass a computer competency test and a typing test with a 90% pass rate. Previous experience in customer service or medical office management is a plus.
Performance Metrics:
Complete 25-35 phone calls daily. Fax denial letters to providers as required.Interested candidates please send resume in Word format Please reference job code 248056 when responding to this ad.
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