Appeals Specialist
Pyramid Consulting•Austin, TX
•Onsite
About The Position
Pyramid Consulting, Inc. is hiring an Appeals Specialist for an immediate, onsite contract opportunity in Austin, Texas. The initial contract is six or more months, with long-term potential. The role involves tracking and processing appeals, disputes, and reconsiderations; investigating requests; researching cases to support timely decisions; and maintaining documentation and case files. The position pays $23 per hour. Benefits include health insurance (medical, dental, and vision), a 401(k) plan, and paid sick leave, depending on work location.
Requirements
- At least 2 years of experience in appeals, reviewing claims, coding, and authorizations.
- Experience with TruCare and Amisys systems.
- High school diploma or GED.
Nice To Haves
- Knowledge of the appeals, disputes, and reconsiderations process.
Responsibilities
- Enter data to track, log, and process appeals, disputes, and reconsiderations in accordance with established guidelines.
- Prepare correspondence and maintain documentation files for appeals, disputes, and reconsiderations.
- Review and investigate requests to determine necessary follow-up actions.
- Research cases to evaluate and respond to appeals, ensuring timely decisions.
- Prepare case files with supporting documentation for review and reporting.
- Gather data to track trends and outcomes, including outreach for status updates and explanations.
- Comply with all policies and standards.
- Perform other duties as assigned.
Benefits
- Health insurance, including medical, dental, and vision coverage.
- 401(k) plan.
- Paid sick leave, depending on work location.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Education Level
High school or GED
