Provider Dispute Resolution Specialist

A company is looking for a Provider Dispute Resolution Specialist who will be responsible for reviewing, researching, and resolving provider disputes in compliance with regulatory guidelines and internal policies. Key Responsibilities Investigate and resolve provider disputes related to denied, underpaid, or incorrectly processed claims Utilize EZCap to review claims history, adjudication data, and notes Document findings and resolutions according to compliance standards Required Qualifications High school diploma or equivalent; associate or bachelor's degree is a plus 1-2 years of provider dispute resolution experience in healthcare or claims processing environments Hands-on experience with EZCap is strongly preferred Familiarity with Medi-Cal and Commercial insurance claims Ability to manage multiple tasks and meet deadlines

May 5, 2025 - 18:15

A company is looking for a Provider Dispute Resolution Specialist who will be responsible for reviewing, researching, and resolving provider disputes in compliance with regulatory guidelines and internal policies. Key Responsibilities Investigate and resolve provider disputes related to denied, underpaid, or incorrectly processed claims Utilize EZCap to review claims history, adjudication data, and notes Document findings and resolutions according to compliance standards Required Qualifications High school diploma or equivalent; associate or bachelor's degree is a plus 1-2 years of provider dispute resolution experience in healthcare or claims processing environments Hands-on experience with EZCap is strongly preferred Familiarity with Medi-Cal and Commercial insurance claims Ability to manage multiple tasks and meet deadlines