BusinessOperations - Appeals Specialist II

Immediate need for a talented BusinessOperations - Appeals Specialist II. This is a 06+months contract opportunity with long-term potential and is located in Houston City, TX(Onsite). Please review the job description below and contact me ASAP if you are interested.
Job ID:26-30759
Pay Range: $23 /hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Responsibilities:

• Support the documentation and processing of appeals, disputes, and reconsiderations.
• Perform data entry to track, log, and process appeals in accordance with regulatory guidelines.
• Prepare correspondence and maintain documentation files for appeals and disputes.
• Review and investigate requests to determine applicable follow-up actions.
• Conduct research to evaluate and respond to appeals, ensuring timely decisions.
• Prepare case files with supporting documentation for review and reporting.
• Gather data to track and report on trends and outcomes, conducting outreach as necessary.
• Comply with all policies and standards while performing other duties as assigned.

Key Requirements and Technology Experience:

• High School diploma or GED required.
• 1 2 years of related experience preferred.
• Knowledge of appeals, disputes, and reconsiderations process is a plus.

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
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