Denial Specialist II

Job Summary

A company is looking for a Denial Specialist II (UM/Behavioral Health).

Key Responsibilities

• Generate and process provider and member correspondence for preservice and concurrent reviews
• Update and maintain correspondence templates based on regulatory and interdepartmental inquiries
• Coordinate data collection, analysis, and reporting activities related to the denial process

Required Qualifications

• High School diploma or GED
• 1 - 2 years of related experience
• Knowledge of the denials process and medical record information preferred
• Familiarity with utilization management and/or behavioral health preferred
• Experience with TruCare Classic or Cloud preferred