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 randstadusa.com 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

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

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 randstadusa.com.

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.