Healthcare Data Entry Specialist - Grievance & Appeals (Remote - East Coast Preferred)

TEKsystems
$20.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, Connecticut, Hartford
Jun 26, 2025
Job Posting: Healthcare Data Entry Specialist - Grievance & Appeals (Remote - East Coast Preferred) Job Title: Healthcare Data Entry Specialist - Grievance & Appeals Job Category: Data Entry Clerk Location: Remote (East Coast candidates preferred) Schedule: Monday - Friday, 9:00 AM - 5:00 PM EST Industry: Health Insurance Pay Rate: $20/hour Position Overview We are seeking a detail-oriented and experienced Healthcare Data Entry Specialist - Grievance & Appeals to support a critical project for a client of TEKsystems, a leading health insurance provider. This fully remote role is focused on helping the client address a significant backlog of over 10,000 appeals and grievances. If you have a background in healthcare data entry, claims processing, and customer service, this is your opportunity to make a meaningful impact in a high-visibility role. Note: While this is a remote position, candidates located on the East Coast are strongly preferred to align with the client's business hours and team collaboration needs. Preference will be given to candidates with prior experience in the healthcare industry. About the Client Our client is a major player in the health insurance industry, known for delivering high-quality, affordable care to millions of members. This role directly supports their mission to improve healthcare access and outcomes by ensuring timely and accurate processing of appeals and grievances. Focus Area: Grievance & Appeals This role is centered around the Grievance & Appeals process, a critical function in ensuring that members and providers receive fair and timely resolutions to their concerns. You will be responsible for reviewing, classifying, and processing complaints and appeals related to health insurance claims, services, and coverage decisions. Your work will directly impact member satisfaction, regulatory compliance, and the overall quality of care delivery. Key Responsibilities * Review and process appeals and grievances submitted by members and providers. * Ensure compliance with NCQA, CMS, state, and other regulatory standards. * Accurately enter and manage data related to health insurance claims, grievances, and appeals. * Communicate effectively with internal departments and external stakeholders to resolve issues. * Conduct thorough investigations and prepare detailed case summaries for medical and administrative review. * Draft clear and accurate written responses to member and provider correspondence. * Monitor and manage personal worklists to ensure timely resolution of cases. * Identify process improvement opportunities and provide feedback to management. Must-Have Skills * Data Entry * Health Insurance Knowledge * Grievances & Appeals Processing * Claims Management * Medical Records Handling * Medical Terminology * Patient Access or Service Coordination Nice-to-Have Skills * Experience with Coventiti or CAGE systems * Managed Care or Compliance Background * Familiarity with NCQA and CMS Guidelines Qualifications * 3+ years of relevant professional experience in healthcare or insurance * Strong written and verbal communication skills * Proficiency in Microsoft Office (Word, Excel, Outlook) * Excellent organizational, analytical, and problem-solving abilities * Ability to work independently in a fast-paced, remote environment Pay and Benefits The pay range for this position is $20.00 - $20.00/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 Jul 9, 2025. h4>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.