Denial Specialist

Denial Specialist (Remote)

Pay Rate: $22.47/hr

Remote: Must reside in US

Schedule: Tuesday Saturday, 1:00 PM 10:00 PM CST

Contract with potential to extend: 1/12/26 - 12/11/2026

Position Overview

The Denial Specialist generates, processes, and maintains provider and member correspondence related to preservice and concurrent reviews. This role supports denial workflows by ensuring accurate documentation, timely communication, and compliance with regulatory standards.

Key Responsibilities

• Generate and process correspondence using EMR documentation within required timelines.
• Review incoming faxes and upload documentation into the electronic medical record system.
• Maintain and update correspondence templates based on regulatory or interdepartmental needs.
• Coordinate data collection, analysis, and reporting related to the denial process.
• Monitor compliance and turnaround time (TAT) logs for all notifications.
• Fax denial letters to providers.
• Make 25 35 outbound calls per day.
• Perform additional duties as assigned while adhering to all policies and standards.
  
  

Qualifications

Education

• High school diploma or GED required.
  
  

Experience

• 1 2 years of related experience.
• Knowledge of the denials process and medical record information preferred.
• Background in customer service or medical office administration is highly beneficial.
  
  

Skills

• Strong computer skills; proficiency with Microsoft Office and Microsoft Teams.
• Familiarity with medical terminology.
• Preferred: HCPCS/CPT coding knowledge.
  
  

Work Environment

• Fully remote; candidates may be located in any U.S. time zone.
• Not member-facing and not required to work onsite.
• Training provided on day one, including system setup and onboarding.
  
  

Additional Requirements

• Computer competency and typing test (90% pass score).
  
  

Interview Process

• One virtual interview with the hiring manager.
  
  

CLIENT does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.