Dispute Resolution Reviewer

Job Summary

A company is looking for a Dispute Resolution Reviewer.

Key Responsibilities

• Review medical records and case files, writing clear and impartial decisions
• Make independent decisions based on medical evidence and relevant regulations
• Conduct research and stay updated on changes in regulations and healthcare practices

Required Qualifications

• Associate's degree or 60+ credits in healthcare or related discipline
• At least one year of experience in Medicare appeals or healthcare compliance
• Experience in medical review or regulatory interpretation preferred
• Ability to research and analyze policies and regulations
• Proficient in using personal computers and relevant applications