[Hiring] Claims Specialist @Pyramid Consulting

Role Description

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

• Support the team in reviewing and processing appeals, disputes, and reconsiderations in accordance with established regulatory and accreditation guidelines.
• Perform data entry to track, log, and process appeals with a focus on accuracy (40 WPM, 90% accuracy).
• Prepare correspondence and maintain documentation files related to appeals and disputes.
• Conduct research to evaluate and respond to claims effectively, ensuring timely decisions.
• Gather data to track trends and final outcomes, conducting outreach for updates as necessary.
• Comply with all policies and standards while performing other duties as assigned.

Qualifications

• 2+ years of healthcare claims and authorization experience, including claims review, provider appeals, denials, or reconsiderations.
• Strong data entry skills (40 WPM, 90% accuracy) and attention to detail.
• Experience with TruCare and AMISYS preferred.
• High School diploma or GED [Required].
• Knowledge of appeals, disputes, and reconsiderations processes.
• Experience in Claims Processing, Utilization Management, and Medical Billing/Coding.

Benefits

• Pay Range: $22 - $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).

Company Description

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