Provider Dispute & Adjustment Specialist

Manages provider disputes and claim adjustments in a health plan environment.

• •The Provider Dispute & Adjustment Specialist manages provider disputes and claim adjustments within a commercial health plan environment.
• •Key Responsibilities Manage provider disputes from initial intake through final resolution.
• •Conduct thorough research into disputed claims by reviewing various documents and regulations.
• •Initiate and process claim adjustments for valid disputes.
• •Requirements Strong analytical and problem-solving skills.
• •Excellent communication and documentation skills.
• •Knowledge of healthcare regulations and billing guidelines.