Provider Billing Disputes (

Remote:

OR, WA, ID, or UT) Motus Recruiting and Staffing

3.0 Portland, OR Job Details Full-time | Contract $25
$29 an hour 1 day ago Benefits Health insurance Dental insurance Vision insurance Qualifications Customer communication High school diploma or GED Full Job Description Appeals Specialist
Provider Billing Disputes Our client, a leading healthcare organization dedicated to improving member and customer experiences, is seeking an experienced Appeals Specialist
Provider Billing Disputes to join their team.

This role is ideal for professionals with expertise in provider billing disputes, provider appeals, and the Independent Dispute Resolution (IDR) process. You'll manage the full lifecycle of provider appeals, researching complex claims, interpreting reimbursement policies and provider contracts, coordinating with coding specialists and clinical reviewers, and ensuring timely, accurate appeal resolutions. If you enjoy investigative work, solving complex reimbursement issues, and delivering exceptional service in a fast-paced healthcare environment, we'd love to hear from you.

Type:

Contract, Duration Pay Range:

$25.00

00/hr.,

DOE Location:

100% Remote Candidates MUST reside in Oregon, Washington, Idaho, or Utah Candidates must be able to work Pacific Time Zone hours Responsibilities of the

Appeals Specialist:

Manage provider billing disputes and appeals from intake through final resolution. Analyze claims, medical coding, reimbursement policies, provider contracts, benefit plans, and applicable regulatory requirements. Investigate complex claim and reimbursement issues to determine appropriate appeal outcomes. Collaborate with coding specialists, appeal nurses, physician reviewers, and other internal partners to support timely and accurate decisions. Coordinate the Independent Dispute Resolution (IDR) process and prepare cases for external review organizations when applicable. Prepare correspondence, documentation, and appeal recommendations while maintaining detailed and accurate case records. Communicate appeal determinations and complex reimbursement information to providers and other stakeholders in a professional and customer-focused manner. Manage a defined caseload while consistently meeting quality, productivity, and regulatory turnaround standards. Identify trends and opportunities for process improvements while supporting compliance with departmental policies and regulatory requirements. Qualifications of the

Appeals Specialist:

High school diploma or GED required. 4+ years of experience in healthcare customer service, claims processing, clinical services, provider appeals, or a related health insurance environment; equivalent combinations of education and experience will also be considered. Experience processing provider billing disputes and provider appeals, including the Independent Dispute Resolution (IDR) process, strongly preferred. Strong knowledge of healthcare claims processing, reimbursement methodologies, and payer operations. Working knowledge of medical terminology, anatomy, and medical coding, including CPT, HCPCS, and ICD-10. Experience interpreting provider contracts, reimbursement policies, and applicable regulatory requirements. Strong analytical, critical thinking, and problem-solving skills with exceptional attention to detail. Excellent written and verbal communication skills with the ability to communicate complex medical and reimbursement information clearly and professionally. Demonstrated ability to prioritize competing deadlines while maintaining accuracy, quality, and a customer-focused approach. Proficiency with Microsoft Office, including Word, Excel, and Outlook. Experience working with health insurance claims systems or payer platforms is highly preferred. Coding certification (CPC, CCS, or similar) is a plus.

We are unable to accommodate corp. to corp. candidates

•

About Motus Recruiting and Staffing, Inc:

Founded in 2006, Motus is an award-winning recruiting and staffing firm in the Pacific Northwest, specializing in professional services and technology solutions. We are a group of people who not only recognize the importance of representation, but actively fight for diversity, equity, and inclusion in the recruitment process. Our goal is to educate organizations on the importance of DEI when hiring, promoting, and supporting diverse employees. We are calling organizations to demonstrate their commitment to DEI by being intentional about who they hire. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, disability or protected veteran status.

KG/BH14245

Pay:

$25.00

$29.

00 per hour

Benefits:

Dental insurance Health insurance Vision insurance Application Question(s): Experience processing provider billing disputes and provider appeals, including the Independent Dispute Resolution (IDR) process?

Experience:

Healthcare customer service, claims, appeals, or insurance: 4 years (Preferred) medical coding (CPT, HCPCS, and ICD-10) : 1 year (Preferred)

License/Certification:

coding certification (CPC, CCS, or similar) (Preferred)

Work Location:

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