Healthcare Dispute Resolution Reviewer

Job Summary

Providing independent dispute resolution, the full-time Healthcare Dispute Resolution Reviewer will review medical records, make determinations based on regulations and evidence, and address appeal issues while working remotely from anywhere in the USA.

Key responsibilities

• Reviews medical records and writes clear, concise dispute resolution decisions
• Makes independent decisions based on medical evidence and applicable regulations
• Conducts research to ensure accurate and well-supported decisions are made

Required qualifications

• Associate's degree or 60+ credit hours towards a Bachelor's degree in healthcare or related discipline
• Three years of experience in medical dispute resolution or Medicare appeals
• Experience in Nursing, Physical Therapy, Respiratory Therapy, or Occupational Therapy preferred
• Demonstrated experience in writing appeal or payment determinations
• Residency in the United States for at least three of the last five years