Appeals specialist

We are hiring for Appeals Specialists with our Heathcare client! These positions are 100% remote TX based. Please inquire if other positions are available if you reside outside of TX. Temp roles to start with opportunity for perm conversion. Pay Rate: $23/hr Hours: M-F, 8AM-5PM CST Start Date: typically 2-3 weeks from offer 100% Remote US TX - equipment is provided The Appeal Specialist II reviews claims to determine authorization requirements, validate existing authorizations, and make necessary authorization updates. The role evaluates claims for medical necessity review eligibility, verifies timely filing and required documentation, and documents findings and next steps for Authorization Builders. Responsibilities also include collaborating with internal teams, ensuring accurate case routing, meeting turnaround time standards, and supporting process improvement efforts.

Cases per day - 50 - 6.25 cases per hour (once trained)

No phones - no contact with providers or members

Receiving cases through system Typing test (minimum 40WPM) and Computer Literacy test (minimum 70%) required. Please email your resume to View email address on click.appcast.io for next steps!

salary: $22.99 - $23 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

The Appeal Specialist II reviews claims to determine authorization requirements, validate existing authorizations, and make necessary authorization updates. The role evaluates claims for medical necessity review eligibility, verifies timely filing and required documentation, and documents findings and next steps for Authorization Builders. Responsibilities also include collaborating with internal teams, ensuring accurate case routing, meeting turnaround time standards, and supporting process improvement efforts.

Cases per day - 50 - 6.25 cases per hour (once trained)

No phones - no contact with providers or members

Receiving cases through system

Skills

• Call Center Support
• Typing Skills
• Telephone Etiquette
• Basic Computer Skills

Qualifications

• Years of experience: 2 years
• Experience level: Experienced

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Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on click.appcast.io.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.