Dispute Resolution Analyst
Job Summary
Supporting the Independent Dispute Resolution programs, the full-time remote Dispute Resolution Analyst will coordinate case files, analyze medical claims, and assist in the reconsideration/dispute resolution process under close supervision.
Key responsibilities
- Coordinates the delivery of re-determination files and dispute resolution documents
- Builds and analyzes case files to ensure compliance with CMS requirements
- Responds to inquiries from appellants and identifies potential fraud or abuse cases
Required qualifications
- One year of experience with provider disputes or claims
- One year of interaction with claims from larger insurance plans
- One year of general office or administrative experience
- High School Diploma or equivalent
Complete Job Description
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