Appeals Specialist II

A-Line Staffing is now hiring an Appeals Specialist II. This is a fully remote opportunity supporting Centene's Medicaid line of business. The Appeals Specialist II would be working for a Fortune 500 healthcare company and has career growth potential. This would be a full-time, 40-hour-per-week position.


If interested, please apply directly or send your resume for immediate consideration.
Appeals Specialist II Compensation

• Pay rate: $23.00 per hour
  
  
• Benefits available to full-time employees after 90 days
  
  
• 401(k) with company match available for full-time employees with 1 year of service
  
  

Appeals Specialist II Highlights

• Fully remote position – open to candidates in any U.S. state
  
  
• Monday – Friday schedule
  
  
• 7:00 AM – 3:30 PM CST (30-minute lunch) or
  
  
• 7:00 AM – 4:00 PM CST (1-hour lunch)
  
  
• No overtime available
  
  
• 6-month assignment
  
  
• Start date: June 8, 2026
  
  

Appeals Specialist II Responsibilities

• Review provider disputes and reconsideration requests from providers and healthcare facilities
  
  
• Transfer and evaluate cases within the CenPAS system
  
  
• Review claims and authorization information using Amisys and other internal systems
  
  
• Research and resolve claims and utilization management inquiries
  
  
• Modify authorizations as appropriate based on case findings
  
  
• Accurately document case activity and resolution outcomes
  
  
• Collaborate with leadership and team members through virtual meetings, huddles, and one-on-one coaching sessions
  
  
• Maintain productivity and quality standards while handling a high-volume workload
  
  
• Develop knowledge across multiple Medicaid health plans and business processes
  
  

Appeals Specialist II Requirements

• High School Diploma or GED required
  
  
• Minimum 2 years of experience in claims processing, utilization management, authorizations, appeals, or related healthcare operations
  
  
• Experience reviewing medical claims and authorizations
  
  
• Familiarity with CenPAS, Amisys, and TruCare systems
  
  
• Strong data entry and typing skills (40+ WPM)
  
  
• Knowledge of medical claims, billing, coding, and reimbursement processes
  
  
• Excellent attention to detail and organizational skills
  
  
• Ability to work independently in a remote environment
  
  

Preferred Background

• Utilization Management experience
  
  
• Medical billing and coding experience
  
  
• Healthcare claims processing experience
  
  
• Experience working with Medicaid health plans
  
  

Performance Expectations

• Complete approximately 50 case reviews per day after training
  
  
• Maintain a monthly quality score of 95% or higher
  
  
• Demonstrate strong accuracy, productivity, and attention to detail
  
  

About the Team
This role supports Centene's Medicaid business and focuses on reviewing provider reconsiderations, claims, and authorization-related cases. The team operates in a collaborative remote environment with ongoing support from leadership through virtual meetings, coaching, and training. This position offers the opportunity to gain exposure to multiple Medicaid health plans while developing expertise in appeals and claims resolution.