Denial Specialist

Denial Specialist

BC Forward is looking for Denial Specialist - Remote


Job Title: Denial Specialist

Location: Remote (West Coast hours)

Duration: 3 months (Potential to extend or convert to FTE)

Schedule: 12 PM - 9 PM CST | One weekend day/month (10 AM - 7 PM CST)

Training Schedule: Mon-Fri, 8 AM - 5 PM CST (2 weeks, camera on)

Target Start Date: September 1

Pay Rate: $23.00/hr on W2

Position Purpose

The Denial Specialist is responsible for generating, processing, and maintaining provider and member correspondence related to preservice and concurrent review decisions. The role supports regulatory compliance and denial process integrity through accurate documentation and timely communication.

Primary Responsibilities

• Generate and process denial letters and correspondence using Electronic Medical Records (EMR).
• Ensure all communications meet compliance standards and regulatory requirements.
• Maintain and update correspondence templates based on internal and external guidelines.
• Coordinate data collection and reporting efforts related to the denial process.
• Assist with tracking turnaround time (TAT) logs and compliance-related metrics.
• Review and process faxes into the EMR system.
• Perform other administrative or compliance tasks as assigned.

Qualifications

Education:

• High School Diploma or GED (Required)

Experience:

• 1-2 years of relevant experience (Required)
• Experience with denial processing, understanding of medical records and terminology (Preferred)

Skills:

• Proficiency in computer applications and EMR systems
• Strong written and verbal communication
• Familiarity with Microsoft OneNote and Teams
• Basic knowledge of medical terminology (Required)
• Experience with HCPCS/CPT coding (Preferred)
• Customer service background (Required)

Performance Expectations:

• Handle 25-35 calls per day
• Ensure timely and compliant correspondence
• Strong attention to detail and ability to work independently

Benefits:

BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

About BCforward:

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.

Interested candidates please send resume in Word format Please reference job code 241241 when responding to this ad.

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