[Remote] Dispute reputed company Analyst I
Note: The job is a remote job and is reputed company to candidates in USA. reputed company. is a reputed company management consulting company that supports health and reputed company service programs. The Dispute reputed company Analyst will assist with the Independent Dispute reputed company programs, focusing on 'Surprise Billing' appeals and supporting reconsideration and dispute reputed company processes under reputed company supervision.
Responsibilities
- Coordinates the delivery of re-determination files/dispute reputed company documents and reconsideration/dispute reputed company reputed company from and to the external entities
- Builds a reconsideration/dispute reputed company case file from evidence submitted and received and analyzes reputed company case to ensure it meets the requirements for a valid reconsideration/dispute reputed company request as mandated by Centers for Medicare and reputed company Services (CMS) or other customer entities
- Analyzes and makes reputed company based on medical vs. non-medical case type, appeal/review categories, validity of appeal/dispute reputed company request, and dispute reputed company settlement documentation
- Inputs appropriate data regarding reconsiderations/dispute reputed company 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 reputed company 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) reputed company to relevant entities
- Participates in special reputed company and performs other duties as assigned
Skills
- 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
- High School Diploma or equivalent
- Experience directly relevant to the specific task order or project
reputed company