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Job Description
- Req#: 18082
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact by ensuring compliance in dispute resolutions
- Engaging role that involves critical analysis and problem-solving
- Comprehensive benefits package offered
What to Expect (Job Responsibilities):
- Investigate closed Federal and State arbitration disputes to identify errors in dispute closures
- Analyze case details, submission history, and correspondence to ensure compliance with applicable standards
- Evaluate closed disputes for potential reopening or correction based on regulatory guidance
- Prepare and submit reopening or correction requests along with necessary documentation
- Serve as a primary resource for post-closure dispute reviews and provide recommendations to management
What is Required (Qualifications):
- High school diploma or equivalent
- 3-4 years of related experience in a relevant field
- Excellent written and verbal communication skills
- Intermediate proficiency in Microsoft Word and Excel
- Strong attention to detail and organizational skills
How to Stand Out (Preferred Qualifications):
- Prior healthcare experience and/or experience with appeals
- Advanced knowledge of payor processes and healthcare billing
- Familiarity with basic medical terminology and concepts
- Knowledge of CPT, ICD-9, and ASA coding
- Ability to work independently with limited supervision
#HealthcareServices #DisputeResolution #CareerOpportunity #Compliance #HealthcareBilling
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