Qualifications & Requirements Experience:

Minimum of 2 years of experience handling appeals, claims, and authorizations.

Industry Background:

Previous roles in Utilization Management, medical billing/coding, or claims processing are highly preferred.

Knowledge Base:

understanding of medical claims, billing/coding practices, and authorization workflows.

Technical Skills:

Proficient data entry and typing skills (minimum 40 WPM) with the ability to quickly learn proprietary software systems.

Work Style:

Self-motivated and comfortable thriving in a fully remote, camera-on environment with virtual supervision and support.

salary:

$22.99 - $23 per hourshift: Firstwork hours: 7 AM - 5

PMeducation:

High SchoolResponsibilitiesReview, evaluate, and resolve provider disputes and reconsideration requests from healthcare facilities and providers. Navigate internal case management systems to analyze claims and determine appropriate resolutions. Modify and manage medical authorizations as needed. Partner and communicate effectively with Utilization Management (UM) and claims departments. Consistently meet established daily case-review productivity targets while maintaining a monthly quality average of 95% or higher. Actively participate in a structured remote onboarding program to learn new processes, systems, and health plan specifics.

SkillsTyping 40 wpmClaims/Codingappeals, authorizations QualificationsYears of experience: 2 yearsExperience level: ExperiencedRandstad 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 HRsupport@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. 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