Dispute Resolution Analyst

Job Summary

A company is looking for a Dispute Resolution Analyst for a contract position in a remote setting.

Key Responsibilities

• Coordinate the delivery of re-determination files and dispute resolution documents
• Build and analyze reconsideration/dispute resolution case files to ensure compliance with CMS requirements
• Respond to inquiries and requests from appellants regarding the reconsideration/dispute resolution process

Required Qualifications

• Some knowledge of research techniques
• Familiarity with the Medicare appeals program
• Understanding of applicable laws, rules, and regulations
• Experience with applicable systems and applications
• Ability to identify instances of fraud and abuse