denials specialist .

Our client is seeking a highly detail-oriented and organized Denials Specialist to join their healthcare administration team. This role is crucial for maintaining compliance with regulatory standards by ensuring accurate and timely processing of medical correspondence, particularly related to the denials process. This is an independent position that requires quick, accurate work and excellent prioritization skills based on strict turnaround times. ***Candidates must be willing to work Tuesday - Saturday 10:00 a.m. to 7:00 p.m.CST *** Candidate must have previous Denial, Appeals or Utilization Management experience to be considered for this role.

salary: $20 - $22.47 per hour
shift: First
work hours: 10 AM - 7 PM
education: High School

Responsibilities

• Generate accurate and compliant correspondence utilizing Electronic Medical Record (EMR) documentation.
• Prioritize and take immediate action on denials as soon as they are presented to meet stringent turnaround times (TAT).
• Process all correspondence tasks in a timely manner to ensure compliance with regulatory standards and policies.
• Note on TAT: Work is based on line-of-business turnaround times (e.g., Inpatient: 24-48 hours vs. Outpatient: 3-5 days).
• Update and maintain correspondence templates based on regulatory changes and interdepartmental correspondence inquiries.
• Coordinate all data collection, analysis, and reporting activities that directly impact the denial process.
• Assist with the maintenance of the compliance and turn-around time (TAT) log for all correspondence notifications.
•  Comply with all organizational policies and standards.
• Perform other duties as assigned to support department operations.
• Knowledge of the denials process, including understanding medical record information, is strongly preferred.

The essential functions of this role include:

working weekends

Skills

Denial Management

Analytical Thinking

Confidentiality

Excel

Appeals

Utilization Management

Medical Terminology

Qualifications

Years of experience: 3 years

Experience level: Experienced

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At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.