Pay Growth
?
out of 5
Not enough data
Not enough info to score pay or growth
Claims Disputes Specialist - Healthcare Provider - Onsite/ Baton Rouge, LA - Contract Position
Job
Elite Technical
Baton Rouge, LA (In Person)
Full-Time
Review key factors to help you decide if the role fits your goals.
Job Security
?
out of 5
Not enough data
Calculating job security score...
Total Score
62
out of 100
Average of individual scores
Skill Insights
Compare your current skills to what this opportunity needs—we'll show you what you already have and what could strengthen your application.
Job Description
Healthcare Provider Disputes Specialist This position is 100% onsite at our client''s Baton Rouge Corporate office. Elite Technical is seeking a Healthcare Provider Dispute Specialist. The selected candidate will coordinate the review of all cases by recording and assigning all provider disputes. Prioritizes, organizes, distributes, and tracks incoming mail/case material. Records the flow of information and assigns it to the appropriate person/queues.
- Reviews processed claims to identify valid provider disputes.
- Creates and assigns dispute cases in EPIC to Provider Dispute Specialists for review and resolution.
- Forwards Medical Appeals, FEP appeals, and Correspondence to the appropriate departments in a timely manner.
- Assigns tasks to Provider Disputes Specialist based on review and research of the incoming provider disputes.
- Assists with creating and maintaining electronic files and hard copy paper files; maintains and tracks department cases and files; assists with preparing and issuing reports required for various internal committee meetings and as needed on an ad hoc basis. Assists with updating database for all dispute cases.
- Coordinates intake, tracking, and distribution of provider disputes, appeals, and correspondence.
- Assists leadership with administrative support, case reporting, and file maintenance while ensuring compliance with privacy and regulatory requirements. Required Skills
Education:
High School Diploma or equivalent is required.- 2 years of general medical/insurance office experience with either claims processing knowledge or provider/member servicing is required.
- Must have strong experience reviewing and researching incoming provider disputes.
- Must have experience using Microsoft Office applications, including Word, Excel and PowerPoint.
- Facets experience is preferred.