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Job Requirements of Denial Specialist II - J00915:
-
Employment Type:
Contractor
-
Location:
Copper, OR (Onsite)
Do you meet the requirements for this job?
Denial Specialist II - J00915
BC Forward
Copper, OR (Onsite)
Contractor
Denial Specialist II - J00915BC Forward is looking for Denial Specialist II (Remote EST/CST)
Position Title: Denial Specialist II (Remote EST/CST) Location: Remote EST/CST
Anticipated Start Date: 03/23
Duration: 12 months
Job Type: Contract with extension/conversion to FTE Shift: Training includes a 3-week Learning Journey (8:00 AM-5:00 PM EST; hours may vary if start date differs), followed by 6 weeks of department-specific training on either 9:30 AM-6:30 PM EST or 10:00 AM-7:00 PM EST schedules, then a regular Monday-Friday shift of 1:00 PM-10:00 PM EST with rotating holidays and occasional weekends as needed.
Pay Rate: $23/hour(W2)
Need: Minimum 1+ year experience processing healthcare denial management systems, including claims, correspondence platforms, and appeals tracking.
Interview Process: 1-Phone Screen, 2-Virtual
Job Description:
Denial Specialist II
Position Purpose
Generates, processes, and maintains provider and member correspondence for preservice and concurrent review.
Education/Experience
Key Responsibilities
Daily Schedule (OT Requirements)
Training - Learning Journey
Story Behind the Need
Purpose of this Team
Generates, processes, and maintains provider and member correspondence for preservice and concurrent review.
Work Environment
N/A
Typical Day in the Role
Day-to-Day Responsibilities
Candidate Requirements
Education/Certification
Top 3 Must-Have Hard Skills (Ranked)
Multitasking, tech-savvy
Ability to adapt to change well
Attention to detail; proficiency in Excel, Outlook, Word, Teams, and OneNote
Candidate Review & Selection
Projected Manager Candidate Review Date: ASAP
Interview Type
Position Title: Denial Specialist II (Remote EST/CST) Location: Remote EST/CST
Anticipated Start Date: 03/23
Duration: 12 months
Job Type: Contract with extension/conversion to FTE Shift: Training includes a 3-week Learning Journey (8:00 AM-5:00 PM EST; hours may vary if start date differs), followed by 6 weeks of department-specific training on either 9:30 AM-6:30 PM EST or 10:00 AM-7:00 PM EST schedules, then a regular Monday-Friday shift of 1:00 PM-10:00 PM EST with rotating holidays and occasional weekends as needed.
Pay Rate: $23/hour(W2)
Need: Minimum 1+ year experience processing healthcare denial management systems, including claims, correspondence platforms, and appeals tracking.
Interview Process: 1-Phone Screen, 2-Virtual
Job Description:
Denial Specialist II
Position Purpose
Generates, processes, and maintains provider and member correspondence for preservice and concurrent review.
Education/Experience
- Requires a High School diploma or GED
- Requires 1-2 years of related experience
- Knowledge of the denials process, including understanding medical record information, preferred
Key Responsibilities
- Generates correspondence from EMR documentation and ensures correspondence tasks are processed in a timely manner to ensure compliance according to regulatory standards and policies
- Updates and maintains correspondence templates based on regulatory and interdepartmental correspondence inquiries
- Coordinates all data collection, analysis, and reporting activities that impact the denial process
- Assists with the compliance and turnaround time (TAT) log for all correspondence notifications
- Performs other duties as assigned
- Complies with all policies and standards
Daily Schedule (OT Requirements)
Training - Learning Journey
- 3-week course (3/16 and/or 4/6) from 8:00 AM - 5:00 PM EST
- If starting on a different date than aligned with the learning journey, hours may vary until training begins
- After the 3-week learning journey, candidates will complete 6 weeks of department-specific training
- Assigned trainer schedule:
- 9:30 AM - 6:30 PM EST or
- 10:00 AM - 7:00 PM EST
- 9:30 AM - 6:30 PM EST or
- Monday-Friday: 1:00 PM - 10:00 PM EST
- Rotating holidays and some weekend coverage if needed
Story Behind the Need
Purpose of this Team
Generates, processes, and maintains provider and member correspondence for preservice and concurrent review.
Work Environment
- Remote position
- Monday-Friday, 1:00 PM - 10:00 PM EST
- Rotating holidays and occasional weekend coverage
N/A
Typical Day in the Role
Day-to-Day Responsibilities
- Process denial management systems (claims, correspondence platform, appeals tracking)
- Prioritize tasks: review pending denial letters, escalations, and compliance deadlines
- Check emails and updates for policy changes, payer updates, or internal communications affecting denial handling
- Once fully trained:
- At least 4 denial letters per hour, and/or
- At least 6-7 approval letters per hour
- At least 4 denial letters per hour, and/or
- Remote specialists manage time and productivity without in-office oversight
- Combines technical expertise, compliance knowledge, and strong communication skills in a virtual setting
- Excel
- Outlook
- Word
- Teams
- OneNote
Candidate Requirements
Education/Certification
- Required: High School / Medical Terminology
- Preferred: N/A
- Required: N/A
- Preferred: N/A
- Minimum 1+ year processing healthcare denial management systems (claims, correspondence platform, appeals tracking)
- Cannot work shift times or not open to holiday coverage
- 60 words per minute
Top 3 Must-Have Hard Skills (Ranked)
Candidate Review & Selection
Projected Manager Candidate Review Date: ASAP
Interview Type
- Microsoft Teams - Camera ON
- Typing test: 60 WPM - 95% accuracy
- Computer literacy test - agency must attach with resume
- Applications: Excel, Outlook, Word, Teams, OneNote
Interested candidates please send resume in Word format Please reference job code 250268 when responding to this ad.
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