Employer Industry: Business and Technology Services

Why consider this job opportunity:
- Hourly rate of $18.00
- Opportunity for career advancement and growth within the organization
- Work remotely from anywhere in the U.S.
- Chance to make a significant impact on provider dispute resolution and compliance
- Supportive and collaborative work environment
- Engage with a leading global innovator in business and technology services

What to Expect (Job Responsibilities):
- Review, investigate, and resolve written provider disputes related to denied or incorrect payments
- Interpret provider and health plan contracts to ensure accurate claims processing
- Adjust claims as needed, including calculating interest and penalties
- Document disputes accurately in the Provider Dispute Database for reporting purposes
- Communicate dispute outcomes clearly and concisely to providers in writing

What is Required (Qualifications):
- High school diploma or GED
- 3+ years of experience as a Claims Examiner with Medicare and HMO experience
- 2+ years of recent experience with Xcelys
- 2+ years of experience with medical terminology (ICD9, ICD10, CPT4, HCPCs, UB04, CMS 1500 forms)
- 1+ year of experience with Revenue and HCPCS coding practices

How to Stand Out (Preferred Qualifications):
- Previous auditing and appeals experience

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