Immediate need for a talented Business Operations - Appeals Specialist II. This is a 06+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review the job description below and contact me ASAP if you are interested.
Job ID:26-32070
Pay Range: $23/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:
- Support the documentation and processing of appeals, disputes, and reconsiderations.
- Perform data entry to track, log, and process appeals in compliance with regulatory guidelines.
- Prepare correspondence and maintain documentation files for appeals and disputes.
- Review and investigate requests to determine necessary follow-up actions.
- Conduct research to evaluate and respond to appeals, ensuring timely decisions.
- Prepare case files with supporting documentation for appeals and disputes.
- Gather and report data on trends and outcomes related to appeals, including outreach for status updates.
- Comply with all policies and standards while performing other duties as assigned.
Key Requirements and Technology Experience:
- High School diploma or GED.
- 1 – 2 years of related experience.
- Knowledge of the appeals, disputes, and reconsiderations process is preferred.
- Additional experience in healthcare or regulatory environments.
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, color, 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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