Denial Specialist II - J00915

TEKsystems•Eugene, OR

1d•$23 - $23•Remote

About The Position

The Denial Specialist II is responsible for generating, processing, and maintaining provider and member correspondence for preservice and concurrent review. This role ensures compliance with regulatory standards and supports denial management systems through accurate documentation, appeals tracking, and timely communication.

Requirements

High School diploma or GED.
1–2 years of related experience in healthcare claims, denial management, or administrative support.
Strong attention to detail and ability to prioritize tasks under compliance deadlines.
Proficiency in Microsoft Office applications (Excel, Outlook, Word), Teams, and OneNote.
Ability to adapt to change, multitask effectively, and maintain accuracy in a fast‑paced environment.
Excellent written and verbal communication skills.

Nice To Haves

Knowledge of denials process and medical record information.
Typing speed of 60 WPM with 95% accuracy preferred.

Responsibilities

Generate correspondence from EMR documentation and ensure timely processing in compliance with regulatory standards and policies.
Update and maintain correspondence templates based on regulatory requirements and interdepartmental inquiries.
Coordinate data collection, analysis, and reporting activities that impact the denial process.
Process denial management systems including claims, correspondence platforms, and appeals tracking.
Review pending denial letters, escalations, and compliance deadlines to ensure timely resolution.
Monitor emails and updates for policy changes, payer updates, or internal communications affecting denial handling.
Meet production expectations: at least 4 denial letters per hour and/or 6–7 approval letters per hour once fully trained.
Manage productivity independently in a remote environment, combining technical expertise, compliance knowledge, and strong communication skills.
Perform other duties as assigned while complying with all organizational policies and standards.