Denial Specialist II - J00915

Remote - candidates can reside in PST, MST, CST BUT MUST WORK HOURS LISTED IN DAILY SCHEDULE

Hours : 11am-8pm PST / 1pm -10pm CST

Days : Monday through Friday

• Generate Approval and Denial Letters
• Create letters based on authorization outcomes (approved or denied) for Ambetter products.
• Review letters for grammar, clarity, and compliance before sending.
• Follow internal SOPs to minimize errors and maintain high quality scores.
• Coordinate with authorization teams and clinical reviewers for clarification on decisions.
• Monitor work queues and prioritize letters based on turnaround time requirements.
• Verify that letters meet state, federal, and Ambetter-specific regulatory requirements.
• We are driven by meeting turnaround time requirements and our production-driven environments.
• Purpose : Additional staff due to influx for the Ambetter business
• Collaborative and supportive : We value open communication and knowledge sharing
• Professional growth : We promote skill development through training and continuous learning
• Positive morale : Regular team huddles and recognition programs help maintain engagement and motivation.

Position Purpose :

Generates processes and maintains provider and member correspondence for preservice and concurrent review.

• Knowledge of denials process including understanding medical record information preferred.
• Generates correspondence from EMR documentation and ensures correspondence tasks are processed in a timely manner to ensure compliance according to regulatory standards and policies
• Updates and maintains correspondence templates based on regulatory and interdepartmental correspondence inquiries
• Coordinates all data collection analysis and reporting activities that impact the denial process
• Assists with the compliance and turn-around time TAT log for all correspondence notifications
• Performs other duties as assigned
• Complies with all policies and standards
• Experience Level

Entry Level

• Job Type & Location
• This is a Contract position based out of Tacoma, WA.
• Pay and Benefits
• The pay range for this position is $22.47 - $22.47 / hr.

Eligibility requirements apply to some benefits and may depend on your job

classification and length of employment. Benefits are subject to change and may be

subject to specific elections, plan, or program terms. If eligible, the benefits

available for this temporary role may include the following :

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off / Leave (PTO, Vacation or Sick Leave)
• Workplace Type
• This is a fully remote position.
• Application Deadline
• This position is anticipated to close on Dec 21, 2025.

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About TEKsystems :

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.