Appeals Specialist

Job Title: Appeals Specialist IIContract Type / Duration: 6-month contractLocation: RemoteWork Hours: Monday Friday, 8:00 AM 4:30 PM or 8:00 AM 5:00 PM EST (based on schedule)Pay Rate: $23.00/hourJob Summary / OverviewWe are seeking an Appeals Specialist II to support the review and processing of appeals, disputes, and reconsiderations. This role ensures cases are handled accurately, efficiently, and in compliance with regulatory and quality standards. The position involves case investigation, documentation, and coordination to drive timely resolutions.Top Required Skills (Ranked)Experience with claims processing, appeals, disputes, or reconsiderationsKnowledge of prior authorizations or utilization management (UM)Strong data entry, typing (40+ WPM), and ability to navigate multiple systemsPreferred Skills / Nice to HaveExperience with healthcare systems such as CenPAS, TruCare, or AmisysFamiliarity with regulatory standards (e.g., NCQA)Strong research, analytical, and problem-solving skillsEducation RequirementHigh school diploma or GEDCertifications (if applicable)Not requiredAdditional NotesCandidate must be eligible for W-2 employmentNo Corp-to-Corp (C2C) arrangementsMust be legally authorized to work in the U.S. without current or future sponsorshipEqual Opportunity StatementThe client is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, military service, or any other non-merit-based factor.