Denial Specialist II

Denial Specialist

Are you a tech-savvy healthcare professional looking for a fully remote role where your precision directly impacts member care? We are looking for high-energy, independent thinkers to join our Medicaid Health Support team as Denial Specialists. In this vital role, you will be responsible for generating and maintaining critical correspondence for providers and members based on Medical Director reviews. You will join a culture that values technical expertise and compliance, working in a virtual setting that rewards self-motivation and sharp communication skills. If you are ready to combine your medical terminology knowledge with a fast-paced, remote schedule, this is the perfect opportunity to grow your career with a leader in healthcare support.

• 1+ years of experience in healthcare denial management, claims, or appeals tracking.

• command of medical terminology and the ability to interpret medical record information.

• Proficiency in Microsoft 365 (Outlook, Teams, Word, Excel) and overall high computer literacy.

• Exceptional typing skills (60+ WPM with 95% accuracy) and attention to detail.

• Ability to work a set schedule including weekends and rotating holidays

salary: $22.98 - $23 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

Generates correspondence from Medical Director review documentation and ensures correspondence tasks are processed in a timely manner to ensure compliance according to regulatory standards and policies
Prioritize Tasks: Review pending denial letters, escalations, and compliance deadlines.
Check Emails & Updates: Look for policy changes, payer updates, or internal communications that could affect denial handling.
Once fully trained, at least 4 denial letters per hour and/or at least 6-7 approval letters per hour
Remote specialists manage time and productivity without in-office oversight and combines technical expertise, compliance knowledge, and strong communication skills in a virtual setting.
No phone calls
Applications Centene – Trucare classic/cloud,
Applications other – Outlook, Teams, one note, excel, word, one drive

Skills

• Multi-tasking
• Adapt to change
• Attention to detail

Qualifications

• Years of experience: 1 year
• Experience level: Experienced

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 [email protected].

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.