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Dispute Resolution Reviewer

Company: VirtualVocations
Location: Vista
Posted on: May 10, 2025

Job Description:

A company is looking for a Dispute Resolution Reviewer.
Key Responsibilities

Review Explanation of Benefits (EOBs) and appeals from providers and health plans under the No Surprises Act
Resolve disputes related to out-of-network provider charges by following detailed internal policies
Research service codes, fees, and coverage policies using digital tools and online databases

Required Qualifications

1+ year of experience in medical coding or billing
Experience handling insurance claims from the payer side
Ability to read and interpret EOBs, remark codes, and medical claim language
Familiarity with dispute resolution, appeals processes, and healthcare regulations
Associate's degree preferred, or 3+ years of total medical billing/coding experience

Keywords: VirtualVocations, Lake Elsinore , Dispute Resolution Reviewer, Other , Vista, California

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