We have other current jobs related to this field that you can find below

  • Director - Construction Dispute Resolution

    4 weeks ago

    Atlanta, United States Socotec Full time

    Job DescriptionJob DescriptionCompany DescriptionSOCOTEC Advisory, LLC., is a subsidiary of Socotec USA, an industry leader in dispute resolution, project advisory, building envelope design, structural failure analysis and energy efficiency consulting services. Socotec’s portfolio of companies is equipped to provide an enhanced scope of solutions to our...

  • Director - Construction Dispute Resolution

    7 days ago

    Atlanta, United States Socotec Full time

    Job DescriptionJob DescriptionCompany DescriptionSOCOTEC Advisory, LLC., is a subsidiary of Socotec USA, an industry leader in dispute resolution, project advisory, building envelope design, structural failure analysis and energy efficiency consulting services. Socotec’s portfolio of companies is equipped to provide an enhanced scope of solutions to our...

  • Senior Manager

    4 weeks ago

    Atlanta, United States Socotec Full time

    Job DescriptionJob DescriptionCompany DescriptionSOCOTEC Advisory, LLC., is a subsidiary of Socotec USA, an industry leader in dispute resolution, project advisory, building envelope design, structural failure analysis and energy efficiency consulting services. Socotec’s portfolio of companies is equipped to provide an enhanced scope of solutions to our...

  • Disputes Supervisor

    3 weeks ago

    Atlanta, Georgia, United States teamworkonline Full time

    At PrizePicks, we are the fastest growing sports company in North America, as recognized by Inc As the leading platform for Daily Fantasy Sports, we cover a diverse range of sports leagues, including the NFL, NBA, and Esports titles like League of Legends and Counter-Strike. Our team of over 450 employees thrives in an inclusive culture that values...

  • Senior Director, Construction Disputes

    4 weeks ago

    Atlanta, Georgia, United States Ankura Consulting Group Full time

    Ankura is a team of excellence founded on innovation and growth.Practice OverviewAnkura's Global Construction professionals are recognized as leading experts in providing construction dispute resolution and advisory services for some of the world's most complex construction projects. Ankura's construction experts provide services to clients on construction...

  • Resolutions Analyst

    3 months ago

    Atlanta, United States Aon Full time

    Aon is looking for a Resolutions Analyst We are looking for a Resolution Analyst who will handle benefit and enrollment related escalations received from our call centers. The Resolution Analyst is responsible for assisting our client's customers with benefit, cancellation and enrollment related issues. There are production and quality expectations...

  • Customer Service Representative

    3 weeks ago

    Atlanta, United States Equifax Full time

    Equifax is where you can power your possible. If you want to achieve your true potential, chart new paths, develop new skills, collaborate with bright minds, and make a meaningful impact, we want to hear from you. As a Customer Service Representative supporting NCTUE (National Consumer Telecom Utilities and Exchange Service Center) consumers' first point of...

  • Customer Service Representative

    2 days ago

    Atlanta, United States Equifax Full time

    Equifax is where you can power your possible. If you want to achieve your true potential, chart new paths, develop new skills, collaborate with bright minds, and make a meaningful impact, we want to hear from you. As a Customer Service Representative supporting NCTUE (National Consumer Telecom Utilities and Exchange Service Center) consumers' first point of...

  • Senior Analyst, Readiness Resolution

    1 day ago

    Atlanta, United States HOME DEPOT U.S.A., INC. Full time

    Position Purpose: The ISE Sr. Analyst Readiness & Resolution is responsible for ensuring project readiness before deployment and for driving resolution of key issues for projects that directly impact customers shopping experiences in Home Depot stores. This position partners with multi-functional teams consisting of approximately 10- 15 individuals from...

  • Disputes Supervisor

    1 month ago

    Atlanta, Georgia, United States teamworkonline Full time

    PrizePicks Chargeback Disputes SupervisorPrizePicks, a leading Daily Fantasy Sports platform covering diverse sports leagues, is looking for a Chargeback Disputes Supervisor to lead the Chargeback Representments Team. This role involves managing evidence submission, tracking success rates, and ensuring quality and efficiency. If you have experience in...

  • Business Operations Analyst, Project Readiness and Resolution

    6 hours ago

    Atlanta, Georgia, United States HOME DEPOT U.S.A., INC. Full time

    Job SummaryWe are seeking a highly skilled Business Operations Analyst to join our team at Home Depot U.S.A., Inc. as a Senior Business Analyst, Readiness and Resolution. This key role will be responsible for ensuring project readiness before deployment and driving resolution of key issues that impact customers' shopping experiences in our stores.Key...

  • Claims Resolution Specialist

    2 days ago

    Atlanta, Georgia, United States Northside Hospital Inc. Full time

    Job SummaryNorthside Hospital Inc. is seeking a highly skilled Claims Resolution Specialist to join our team. As a Claims Resolution Specialist, you will be responsible for resolving denied claims and ensuring timely payment from insurance carriers.Key ResponsibilitiesDraft and submit written letters of appeal to insurance carriers for denied claims.Utilize...

  • Claims Resolution Specialist

    19 hours ago

    Atlanta, Georgia, United States Northside Hospital Inc. Full time

    Job SummaryNorthside Hospital Inc. is seeking a highly skilled Claims Resolution Specialist to join our team. As a Claims Resolution Specialist, you will be responsible for resolving denied claims and ensuring timely payment from insurance carriers.Key ResponsibilitiesDraft and submit written letters of appeal to insurance carriers for denied claims.Utilize...

  • Accounts Receivable Analyst

    2 months ago

    Atlanta, Georgia, United States Norfolk Southern Corp. Full time

    Requisition 37668: Accounts Receivable Analyst A resume helps you stand out to hiring managers and recruiters; your resume communicates your experience and your brand. While it is not required, we encourage you to include an up-to-date resume along with a completed job application to give you the best opportunity to be considered. A complete resume helps us...

  • Credit Analyst

    3 days ago

    Atlanta, United States Accountants One Full time

    Accountants One has been hired by a repeat Fortune 500 manufacturing client to assist them in finding a credit analyst to join their team. This global manufacturing company is HQ in Atlanta.The credit analyst will ensure that customer credit risk is properly evaluated and monitored to optimize working capital and profitability for a specific customer...

  • Credit Analyst

    1 week ago

    Atlanta, United States Accountants One Full time

    Accountants One has been hired by a repeat Fortune 500 manufacturing client to assist them in finding a credit analyst to join their team. This global manufacturing company is HQ in Atlanta. The credit analyst will ensure that customer credit risk is properly evaluated and monitored to optimize working capital and profitability for a specific customer...

  • Corporate Treasury Analyst

    2 weeks ago

    Atlanta, United States Rollins Full time

    Overview Ready to do meaningful work with an industry leader? We are seeking top talent to join the Treasury Team! Our Treasury Analyst will support treasury operations and will report to the Senior Treasury Manager. The position is responsible for supporting general treasury operations including performing daily cash management, cash forecasting and...

  • Financial Treasury Analyst

    24 hours ago

    Atlanta, Georgia, United States Rollins Full time

    Position Overview:Join a leading organization in the pest management industry as a Treasury Analyst. This role is pivotal in supporting the treasury functions and will report directly to the Senior Treasury Manager. The selected candidate will be integral in managing treasury operations, including daily cash oversight, forecasting, and bank...

  • Account Analyst I

    2 months ago

    Atlanta, Georgia, United States Norfolk Southern Corp. Full time

    Exciting Opportunity at Norfolk SouthernNorfolk Southern, a company with a rich legacy spanning almost two centuries, is currently looking for a dedicated Account Analyst to join their team in Atlanta, GA. As an Account Analyst at Norfolk Southern, you will play a crucial role in managing accounts receivable and interacting with customers to ensure revenue...

  • Cash Management Analyst

    6 days ago

    Atlanta, Georgia, United States Rollins Full time

    Position Overview:Join a leading organization in the pest management industry as a key member of the Treasury Team. We are looking for a dedicated Treasury Analyst to assist in the management of treasury functions and report directly to the Senior Treasury Manager.Key Responsibilities:Oversee daily cash management activities, including cash positioning, fund...

Medical Dispute Resolution Analyst

2 months ago

Atlanta, United States J29 Full time
Job DescriptionJob DescriptionSalary: 17.30/hour

General Description:

J29 is a healthcare management company with significant experience providing clinical, policy, and administrative review and analysis of some of the nations most complex healthcare programs. Established in 2017, J29 prides itself on its employee centric culture and high employee retention rates. Our team brings corporate performance that stretches to various areas of the Department of Health and Human Services, such as the Centers for Medicare and Medicaid Services (CMS), and Health Resources and Services Administration.

 

As a Dispute Resolution Analyst (DRA) you’ll support the Independent Dispute Resolution (IDR) programs that handle routine 'Surprise Billing' appeals work. This role will serve as a support person for the reconsideration/dispute resolution professionals and physician reviewers for second level reconsiderations/dispute resolutions. Additionally, the DRA position will work under close supervision, with minimal latitude for the use of initiative and independent judgement. 

 

Essential Responsibilities:

  • Coordinates the delivery of re-determination files/dispute resolution documents and reconsideration/dispute resolution decisions from and to the external entities.
  • Builds a reconsideration/dispute resolution case file from evidence submitted and received and analyzes each case to ensure it meets the requirements for a valid reconsideration/dispute resolution request as mandated by Centers for Medicare and Medicaid Services (CMS) or other customer entities.
  • Analyzes and makes decisions based on medical vs. non-medical case type, appeal/review categories, validity of appeal/dispute resolution request, and dispute resolution settlement documentation.
  • Inputs appropriate data regarding reconsiderations/dispute resolution cases into the applicable required systems.
  • Responds to reconsideration/dispute review requests from appellants/patients/providers.
  • Routes or responds to telephonic and/or written inquiries from appellants/patients about reconsiderations/dispute resolution or about the reconsiderations/dispute resolutions process from appellants/patient or their legally-designated representatives.
  • Identifies any suspected instances of fraud and/or abuse and immediately inform management of such issues.
  • Stays abreast of changes in regulations and practices, policies and procedures.
  • May submit requests for re-determination files and completed reconsideration and Administrative Law Judge (ALJ) decisions to relevant entities.
  • Participates in special projects and performs other duties as assigned.


Minimum Qualifications

Education

  • High School Diploma or equivalent

 

Experience

  • One (1) years of experience with Provider disputes or claims
  • One (1) years of interaction with claims with larger insurance plans
  • One (1) year of general office or administrative experience
  • Experience directly relevant to the specific task order or project, preferred


Knowledge, Skills and Abilities

 

Some Knowledge of

  • Research techniques
  • Medicare appeals program
  • Applicable systems and applications
  • Applicable laws, rules and regulations


Some Skill in

  • Preparing correspondence/documents using correct spelling, grammar and punctuation; proofreading and reviewing documents for clarity and consistency
  • Prioritizing and organizing work assignments
  • Researching, analyzing and interpreting policies and state and federal laws and regulations
  • The use of personal computers and applicable programs, applications and systems


Ability to

  • Meet production and quality standards
  • Multitask and meet deadlines
  • Exercise logic and reasoning to define problems, establish facts and draw valid conclusions
  • Make decisions that support business objectives and goals
  • Identify and resolve problems or refer issues appropriately
  • Communicate effectively verbally and in writing
  • Adapt to the needs of internal and external customers
  • Show integrity and ethical behavior; respect confidentiality, business ethics and organizational standards
  • Assure compliance with regulatory, contractual and accreditation entries


Type of Work

  • Hourly/Non-Exempt
  • Temporary (4-6 months) with chance of permanent placement


Location:

  • Remote: US Based
  • CMS regulation require US Residence 3 of the past 5 years.


Why J29?


J29 is an employee centric Federal Contractor that focuses on creating health and IT solutions for the better of the community.  Making company culture the main priority ensures employees satisfaction and retention. We believe in empowering employees to do great things. When you invest in your people, and focus on creating a healthy work life balance, then your employees will take care of your customers and make sure they are happy. One of our sayings is “Work Hard and Be Nice to People” – it really is that simple.


J29 Solutions


Check J29 Inc. out on LinkedIn


EEO Statement


J29, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.


remote work