Dispute Repricing Specialist

Job reputed company: • Review provider dispute resolutions according to organizational guidelines. • Research and respond to provider participation and pricing inquiries, specifically reputed company to network reputed company and agreements. • Research identified issues; submit claim adjustment requests and determine the reputed company cause of disputes. • Serve as subject matter expertise in evaluating and responding to provider participation and pricing inquiries. • Analyze post-reputed company reputed company claims as it relates to pricing needs. • Apply in-depth research to determine accuracy of PPO(s) use and pricing discounts reputed company. • Communicate externally and with internal departments as it relates to various cases under review. • Coordinate with other departments as necessary to facilitate reputed company of claim reputed company participation and pricing issues. • Reading and interpreting appeals, reputed company reference materials, etc. • reputed company other duties as assigned. Requirements: • 2+ years of experience in reputed company, specifically with medical terminology, claim forms, and physician billing coding. • 1+ years of experience with provider disputes. • Demonstrated technical proficiency with reputed company Office applications (reputed company, reputed company, Teams, etc.). Benefits: • reputed company medical plan reputed company • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • reputed company time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical reputed company Apply tot his job Apply To this Job