Denial Specialist II - J00915

Denial Specialist II - J00915

Bcforward is looking for the position Denial Specialist - Remote

Job Title: Denial Specialist
Location: Remote - Louisiana, Arizona, or Colorado
Pay Rate: $23/hour
Assignment Duration: 3 Months (with possibility of extension or conversion)
Start Date: June 2, 2025
Work Schedule: Monday - Friday, 8:00 AM - 5:00 PM CST
(One weekend per month, working 10:00 AM - 7:00 PM CST)

Position Summary:

Bcforward is seeking a Denial Specialist to generate, process, and maintain provider and member correspondence related to preservice and concurrent medical reviews. The ideal candidate will have experience in medical record documentation, correspondence generation, and a working knowledge of the denial process within healthcare settings.

Key Responsibilities:

• Generate correspondence from EMR documentation in compliance with regulatory standards.
• Ensure timely processing of correspondence tasks according to policy and turnaround time (TAT) requirements.
• Update and maintain templates for correspondence based on regulatory and internal department requirements.
• Coordinate data collection, analysis, and reporting activities that affect the denial process.
• Support compliance tracking and documentation for all correspondence notifications.
• Review incoming faxes and upload documentation into the EMR system.
• Fax denial letters and track documentation as required.
• Maintain compliance with all company policies and procedural standards.
• Perform additional duties as assigned.

Required Qualifications:

• High School diploma or GED.
• 1-2 years of related healthcare or administrative experience.
• Strong understanding of medical terminology and medical records.
• Proficient in computer use, including EMR systems, Microsoft Office (Outlook, Teams, Excel).
• Experience in customer service or call center environments (25-35 calls/day expected).

Preferred Qualifications:

• Knowledge of HCPCS/CPT coding.
• Prior experience with denials or medical review processes.
• Familiarity with healthcare compliance standards and interdepartmental communications.

Skills & Attributes:

• Strong attention to detail and organizational skills.
• Excellent verbal and written communication abilities.
• Ability to work independently in a remote environment.
• Collaborative mindset and team-oriented work ethic.

Interested candidates please send resume in Word format Please reference job code 239748 when responding to this ad.

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