Provider Dispute Resolution Specialist - Hybrid
The University of California, San Diego
About this position
Position Description
Responsible for end-to-end claims appeal process including, but not limited to, claim appeal intake, categorization, acknowledgement, resolution, documentation, provider notification, claim reprocessing, tracking, trending and reporting.
Qualifications
Six (6) years of related experience, education/training, OR a Bachelor’s degree in related area plus two (2) years of related experience/training. Related experience: processing professional and facility claims within Epic Tapestry. Working knowledge of common organization- or research-specific and other computer application programs. Proficient in communication and interpersonal skills to communicate effectively, both verbally and in writing. Proficient in ability to use discretion and maintain all confidentiality. Demonstrates ability to use sound judgment in responding to issues and concerns Demonstrates ability to analyze, research and synthesize large amounts of data with strong attention to detail. Proficient in ability to multi-task with demanding timeframes. Working knowledge of applicable policy analysis techniques.