Independent Dispute Resolution Specialist

Job Summary

Independent Dispute Resolution Specialist, a full-time position, is responsible for analyzing healthcare claims, managing the Independent Dispute Resolution process, and ensuring timely resolution of claim issues.

Key Responsibilities

• Analyze healthcare claims to determine next steps, including negotiation or Independent Dispute Resolution (IDR)
• Perform daily audits to identify discrepancies such as zero-dollar payments or negative balances
• Resolve outstanding claim issues promptly while maintaining accurate records of actions taken

Required Qualifications

• Strong analytical skills with experience in healthcare claims analysis
• Experience in auditing and identifying discrepancies in financial records
• Ability to manage a busy inbox and ensure timely responses to inquiries
• Collaboration skills to support team workload balance and efficiency
• Understanding of medical billing and coding related to out-of-network claims