Claims Disputes Specialist - Healthcare Provider - Onsite​/Baton Rouge, LA - Position

Healthcare Provider Disputes Specialist

This position is 100% onsite at our client's Baton Rouge Corporate office.

• Review processed claims to identify valid provider disputes.
• Create and assign dispute cases in EPIC to Provider Dispute Specialists for review and resolution.
• Forward Medical Appeals, FEP appeals, and correspondence to the appropriate departments in a timely manner.
• Assign tasks to Provider Disputes Specialists based on review and research of the incoming provider disputes.
• Assist with creating and maintaining electronic files and hard copy paper files; maintain and track department cases and files; assist with preparing and issuing reports required for various internal committee meetings and as needed on an ad hoc basis; assist with updating database for all dispute cases.
• Coordinate intake, tracking, and distribution of provider disputes, appeals, and correspondence.
• Assist leadership with administrative support, case reporting, and file maintenance while ensuring compliance with privacy and regulatory requirements.

• Education:
  
  High School Diploma or equivalent is required.
• At least 2 years of general medical/insurance office experience with either claims processing knowledge or provider/member servicing.
• Strong experience reviewing and researching incoming provider disputes.
• Experience using Microsoft Office applications, including Word, Excel and PowerPoint.
• Facets experience is preferred.