Denial Specialist

Title: Denial Specialist II

Location: Remote-Oklahoma

Duration: 3 months contractwith potential extension

Target Start Date (based on successful onboarding completion): 04/03/2024

Shift: 8:00 AM - 5:00 PM - Monday - Friday

Walk me through the day-to-day responsibilities of this role and a description of the project):

• Take calls from our internal call center on complex authorization-related issues, attach medical records, process member/provider letters, and process authorization requests. Mainly computer-based, provider-based work.

Describe the performance expectations/metrics for this individual and their team:

• Maintain good working relationships with other departments
• Team goal/state requirement: process 90% (or more) of authorizations and medical records within 24–72-hour turnaround time
• Team goal/state requirement: answer 95% of inbound calls, must answer within 30 seconds
• Individual goal: Process 45 tasks per day (combination of letters, calls, medical records, authorization building)
• Individual goal: Maintain monthly audit score of 90% or higher

Tell me about what their first day looks like:

• IT call, training

What previous job titles or backgrounds work well in this role?

• Call center, customer service, medical terminology knowledge, Insurance experience preferred

Required Skills/Experience/Education:

• 2+ years of RECENT Denial/Referral/Authorization and Customer Service experience in healthcare call center setting.
• Medical Terminology Knowledge, Proficient Microsoft Office, Computer Savvy Skills with prior experience working between multiple screens/monitors and troubleshooting; Ability to Multitask, Ability to adapt to changing work tasks.
• High School Diploma or GED required.
• Must send typing test result (typingtest.com) and Internet Speed Test

Job Type: Contract

Salary: $20.00 - $22.00 per hour

Expected hours: No less than 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Weekly day range:

• Monday to Friday
• Weekends as needed

Experience:

• Healthcare / Medical Insurance: 2 years (Required)
• Call center: 2 years (Required)

Ability to Commute:

• Oklahoma City, OK (Required)

Work Location: Remote