Dispute Resolution Specialist

4 days ago


Los Angeles, California, United States MedPOINT Management Full time
Job Description

We are seeking a highly skilled Dispute Resolution Specialist to join our team at MedPOINT Management. This role involves handling provider dispute resolution processes, ensuring timely and fair resolutions, and maintaining accurate records.

Main Responsibilities:

  • Meet production standards of 25-35 Hospital Provider Dispute claims per day and 50-75 IPA Provider Dispute claims as established by claims management.
  • Collaborate with providers, internal teams, and external stakeholders to resolve disputes in accordance with industry standards and regulatory requirements.
  • Process Customer Services Inquiries and submit automation requests through SharePoint.
  • Assist with training new hires and perform other tasks as assigned by supervisor/manager.
  • Attend training meetings and provide auditor with training suggestions/examples.
  • Adhere to Claims Department policies and procedures, keeping updated materials and resources for accurate and expedient adjudication.

Minimum Job Requirements:

  • A high school diploma or equivalent is required.
  • The successful candidate will have knowledge of medical terminology, ICD-9, CPT-4, treatment of diagnoses, and COB.
  • At least 2 years of experience as an Examiner III is necessary.

Skills and Abilities:

  • The ideal candidate will be able to communicate clearly, tactfully, and professionally with others.
  • Strong detail-oriented skills are essential.
  • Proficiency in computer software packages and the ability to follow directions and work independently are required.
  • Effective communication skills and a willingness to learn new tasks are necessary.
  • Strong organizational and mathematical skills are also required.

Compensation: The estimated annual salary for this position is $62,500 - $72,500, depending on experience and qualifications.



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