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PC

Business Operations - Appeals Specialist II

Pyramid Consulting, Inc
  • 🇺🇸 United States
  • Remote
  • 16 hours ago
  • Health insurance
  • Pension
16 hours ago
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Immediate need for a talentedBusiness Operations - Appeals Specialist II. This is a06+ Months Contract opportunity with long-term potential and is located inUS (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 leadingHealthcare Industryand 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.

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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Business Operations - Appeals Specialist II · Pyramid Consulting, Inc

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