Dispute Resolution Analyst

Job Description: Coordinates the delivery of re-determination files/dispute resolution documents and reconsideration/dispute resolution decisions from and to the external entities. Builds a reconsideration/dispute resolution case file from evidence submitted and received and analyzes each case to ensure it meets the requirements for a valid reconsideration/dispute resolution request as mandated by Centers for Medicare and Medicaid Services (CMS) or other customer entities. Analyzes and makes decisions based on medical vs. non-medical case type, appeal/review categories, validity of appeal/dispute resolution request, and dispute resolution settlement documentation. Inputs appropriate data regarding reconsiderations/dispute resolution cases into the applicable required systems. Responds to reconsideration/dispute review requests from appellants/patients/providers.

Education: High School Diploma or equivalent

Experience: One (1) year of general office experience. College education or technical training in administration, business, or related areas may be substituted for experience on a year per year basis. (Education requirements may be satisfied by full-time education or the prorated part-time equivalent.)Healthcare experience, preferred

Benefits: C2C offers an excellent benefits package, including: Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance Section 125 plan 401KCompetitive salary License/credentials reimbursement Tuition ReimbursementEOE Vet/Disability Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.