In this key role, you will be responsible for generating, processing, and maintaining critical provider and member correspondence for preservice and concurrent medical reviews. Working standard daytime hours (Monday through Friday, 10:00 AM – 7:00 PM PST / 12:00 PM – 9:00 PM CST with rotating holidays), you will prioritize pending denial letters, manage escalations, and review EMR documentation to ensure all correspondence meets strict regulatory deadlines and compliance standards. Once fully trained, you will maintain a steady workflow by completing at least 4 denial letters or 6-7 approval letters per hour. You will utilize electronic medical record systems alongside Microsoft Office tools (Excel, Word, Outlook, Teams, OneNote) to track correspondence tasks and update templates. If you bring a solid understanding of medical terminology, strong time management, and the ability to work independently in a virtual setting, this position offers an engaging platform to showcase your skills.
salary: $22.99 - $23 per hour
shift: First
work hours: 10 AM - 7 PM
education: High School
Responsibilities
Position Summary:
Generate, process, and maintain provider and member denial and approval correspondence using EMR documentation while meeting strict regulatory turnaround times.
Key Responsibilities:
- Review Medical Director documentation and EMR records to generate compliant denial and approval letters.
- Prioritize daily tasks, pending letters, and escalations to adhere to mandatory compliance deadlines.
- Process a minimum of 4 denial letters or 6-7 approval letters per hour post-training.
- Update and maintain correspondence templates based on regulatory standards and departmental inquiries.
- Track data, maintain compliance logs, and monitor correspondence turnaround times.
- High School Diploma or GED required; medical terminology knowledge required.
- Minimum 1 year of experience in healthcare denial processing, claims, or appeals tracking.
- Proficient in Microsoft 365 (Excel, Word, Outlook, Teams, OneNote) and basic computer troubleshooting.
- Fast and accurate typing skills (minimum 60 WPM with 95% accuracy).
- Full availability for a mandatory 6-8 week 1-on-1 virtual training (M-F, 8:00 AM – 5:00 PM PST).
Skills
Qualifications
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
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.
