[Hiring] Business Operations - Appeals Specialist II @Pyramid Consulting

Role Description

Immediate need for a talented Business Operations - Appeals Specialist II. This is a 06+ Months Contract opportunity with long-term potential and is located in US (Remote).

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

Qualifications

• High School diploma or GED.
• 1 – 2 years of related experience.
• Knowledge of the appeals, disputes, and reconsiderations process is preferred.
• Additional experience in healthcare or regulatory environments.

Benefits

• Pay Range: $23/hour.
• Employee benefits include, but are not limited to, health insurance (medical, dental, vision).
• 401(k) plan.
• Paid sick leave (depending on work location).

Company Description

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions.