Payor Dispute Coordinator

Job Description

REQUIREMENTS

• High school diploma or equivalent; some college preferred.
• Proficiency in Microsoft Office required, specifically Excel and Outlook.

• Strong organizational, analytical, and problem-solving skills, including escalating unusual circumstances to management.
• Ability to work independently within a group setting, in a fast-paced, deadline-driven environment.
• Comfortable adapting to frequent process changes and evolving system needs.
• Ability to work with confidential information and demonstrate HIPAA Compliance.
• Strong written and verbal communication skills.
• Professional attitude and appearance that convey confidence, maturity, and competence.
• Commitment to honest and ethical business conduct.
• Will be expected to acquire knowledge and understanding of the following:
  • The Federal Independent Dispute Resolution (IDR) Process
  • Explanation of Benefits (EOBs) and out-of-network payment guidelines
  • Health Plan Provider Portals
  • Athena (GE) Healthcare ETM module
  • Review and identify eligible claims
  • Accurate and compliant claim submission
  • Internal communication and documentation
  • All our client’s compliance regulations

RESPONSIBILITIES

• Support the preparation and filing of payment disputes through the Federal IDR process.
• Analyze underpaid claims and prepare supporting documentation for arbitration.
• Enter and maintain accurate data related to dispute submissions, payer offers, and resolution outcomes.
• Act as a liaison between vendors and internal stakeholders to gather or share information.
• Track, process, and follow up on vendor invoices for arbitration-related services.
• Help ensure disputes are filed in a timely, compliant, and organized manner.
• Collaborate interdepartmentally to support process improvements and complete special projects.
• Learn and apply working knowledge of No Surprise Act, revenue cycle, and physician billing procedures.

Are you interested in this position?

Apply by clicking on the “Apply Now” button below!

#CrossChannelJobs #JobSearch
#CareerOpportunities #HiringNow
#Employment #JobOpenings
#JobSeekers
#FacebookLinkedIn