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PC

Appeals Specialist

Pyramid Consulting, Inc
  • 🇺🇸 United States
  • On-site
  • 20 hours ago
  • Health insurance
  • Pension
20 hours ago
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Immediate need for a talentedAppeals Specialist. This is a06+months contract opportunity with long-term potential and is located inAustin ,TX(Onsite). Please review the job description below and contact me ASAP if you are interested.

Job ID:26-32893

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:
  • Perform data entry to track, log, and process appeals, disputes, and reconsiderations in accordance with established guidelines.
  • Prepare correspondence and maintain documentation files for appeals, disputes, and reconsiderations.
  • 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 review and reporting.
  • Gather data to track trends and outcomes, including outreach for updates on statuses and explanations.
  • Comply with all policies and standards while performing other duties as assigned.
Key Requirements and Technology Experience:
  • 2+ years of experience in appeals, reviewing claims, coding, and authorizations.
  • Experience withTruCare andAmisys systems.
  • High School diploma or GED required.
  • Knowledge of the appeals, disputes, and reconsiderations process preferred.
Our client is a leadingHealthcare 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, colour, 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.
 
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here.

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Appeals Specialist · Pyramid Consulting, Inc

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