Top 6592 Dispute Resolution Professional Jobs

Grievance Resolution Specialist (Provider Resolution)
Aroha Technologies —Orange, CA
- Monday to Friday
- Spanish
- Microsoft Excel
- Microsoft Outlook
Quick Apply
10d
Dispute Resolution Analyst
TMF Health Quality Institute —Remote
- Full-time
- Remote
- Administrative experience
- High school diploma or GED
- Business Administration
- AD&D insurance
- Disability insurance
Dispute Resolution Reviewer III (Healthcare Professional)
TMF Health Quality Institute —Remote
- Full-time
- Remote
- Writing skills
- Research
- Mid-level
- AD&D insurance
- Disability insurance
Remote Support Specialist
AmazingCo —Remote
- $28 - $38 an hour
- Full-time
- Remote
- Google Workspace
- Mid-level
- Administrative experience
- Health insurance
- Dental insurance
Quick Apply
5d
Appeals Professional III (Weekend Work) (Part C)
TMF Health Quality Institute —Remote
- Weekends as needed
- Remote
- Writing skills
- Research
- Mid-level
- 401(k)
- Tuition reimbursement
Managed Care Follow Up Specialist
Elevate Patient Financial Solutions —Remote
- $22.50 - $28.38 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Paid holidays
- Health insurance
Quick Apply
9d
Manager of Compliance Audit
PROVIDER RESOURCES INC —Remote
- $105,000 - $155,000 a year
- Full-time
- Remote
- 5 years
- Senior level
- Analytics
Quick Apply
Banking Analyst - Chargeback & Payments Operations
Transact Campus —Remote
- $65,000 - $105,000 a year
- Full-time
- Remote
- Research
- Mid-level
- Office
- Health savings account
- AD&D insurance
Quick Apply
Sr Dispute Correspondence Specialist (REMOTE)
Carrington Mortgage Holdings —Westfield, IN
- $26 - $29 an hour
- Full-time
- Remote
- Writing skills
- Research
- Mid-level
- Health insurance
- Tuition reimbursement
PROJECT SPECIALIST - HEALTHCARE - REMOTE
iMPROve Health (MPRO) —Remote
- $50,000 - $60,000 a year
- Remote
- Computer literacy
- Mid-level
- Windows
- Disability insurance
- Health insurance
Quick Apply
Dispute Resolution Specialist II
Claritev —Remote
- $19 - $21 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Paid parental leave
- Employee stock purchase plan
Appeals Specialist (Part C)
TMF Health Quality Institute —Remote
- Full-time
- Remote
- Writing skills
- Research
- Mid-level
- AD&D insurance
- Disability insurance
Claims Auditor, Managed Care (remote)
Cedars-Sinai —Los Angeles, CA
- $27.18 - $42.13 an hour
- 8 hour shift
- Remote
- Mid-level
- High school diploma or GED
- Bachelor's degree
- Health insurance
- Dental insurance
CAT Claims Specialist
Frontline Homeowners Insurance —Remote
- Full-time
- Remote
- Mid-level
- 3 years
- Bachelor's degree
- Disability insurance
- Health insurance
Quick Apply
Escalation Specialist
Lake Appliance Repair —Remote
- Full-time
- Local
- Mid-level
- High school diploma or GED
- Paid holidays
- Paid time off
Dispute Resolution Specialist I, II, III, Senior
Global Credit Union —Anchorage, AK
- $45,633 - $90,230 a year
- 8 hour shift
- Microsoft Excel
- Writing skills
- Research
- Health savings account
- Paid holidays
Supervisor (Clinical Adjudication) Weekday Evening Shift - Flexible Scheduling (Part C)
TMF Health Quality Institute —Remote
- Full-time
- Nursing
- Writing skills
- Supervising experience
- AD&D insurance
- Disability insurance
Dispute Resolution Specialist
Better Business Bureau of Minnesota, Inc —Burnsville, MN
- $23 - $25 an hour
- Hybrid work
- Bilingual
- Microsoft Excel
- Microsoft Outlook
- Free parking
- Health savings account
Quick Apply
8d
CLIENT SUCCESS MANAGER- HOME HEALTH CODING & QUALITY ASSURANCE
Cliniqon —Remote
- Email
- Remote
- Mid-level
- 3 years
- Quality control
Quick Apply
12d
Remote Account Resolution Representative
Annuity Health —Reading, PA
- $16 - $26 an hour
- Full-time
- Remote
- Computer literacy
- High school diploma or GED
- Computer skills
- Health savings account
- Paid holidays
Quick Apply

I want to receive the latest job alert for Dispute Resolution Professional

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

Dispute Resolution Professional jobs near

Grievance Resolution Specialist (Provider Resolution)

Aroha Technologies -
Orange, CA

Quick Apply

Job Details

10 days ago

Qualifications

Microsoft Excel
Microsoft Outlook
Word embeddings
Research
High school diploma or GED

Full Job Description

Grievance Resolution Specialist (Provider Resolution)

Job Title: Grievance Resolution Specialist (Provider Resolution)

Location: Orange County, CA (500 City Parkway West)

Work Schedule: Monday Friday | 8:00 AM 5:00 PM

Work Setting: 100% Onsite

Job Overview:

We are seeking a detail-oriented Grievance Resolution Specialist (Provider Resolution) to support the Grievance & Appeals department. In this role, you will investigate provider grievances and appeals, coordinate with internal teams, communicate with providers, and ensure timely, accurate case resolution while maintaining compliance with healthcare regulations.

Key Responsibilities

Review and process provider grievances and appeals.
Gather, analyze, and document case information.
Create and maintain accurate case records and reports.
Communicate with providers and internal departments regarding case status.
Research provider contracts, policies, and regulatory requirements.
Draft professional resolution letters and correspondence.
Respond to provider inquiries by phone and email.
Coordinate with operational teams to resolve complex issues.
Identify trends and recommend process improvements.
Maintain confidentiality and comply with healthcare regulations.
Perform additional administrative duties as assigned.

Minimum Qualifications

High School Diploma or GED.
At least 1 year of experience in one or more of the following:
- Provider Dispute Resolution
- Medicare or Medi-Cal Appeals
- Grievance & Appeals
- Claims Administration
- Regulatory Compliance
- Healthcare Customer Service
Strong written and verbal communication skills.
Ability to work independently and manage multiple priorities.
Proficiency in Microsoft Office (Word, Excel, Outlook, PowerPoint).

Preferred Qualifications

Associate degree in Business, Healthcare Administration, or a related field.
Experience with healthcare practice standards for government and commercial health plans.
Bilingual candidates (Spanish, Vietnamese, Chinese, Korean, Arabic, Farsi, or Russian) are encouraged to apply.

Skills

Strong analytical and problem-solving abilities
Excellent organizational skills
Attention to detail
Ability to manage multiple cases simultaneously
Professional customer service skills

Thanks & Regards,

Amit Singh
Sr. Healthcare Recruiter
Direct: 510-972-5969

#RN2025

Quick Apply

Refine Your Search

Dispute Resolution Professional jobs

Grievance Resolution Specialist (Provider Resolution)

Dispute Resolution Analyst

Dispute Resolution Reviewer III (Healthcare Professional)

Remote Support Specialist

Appeals Professional III (Weekend Work) (Part C)

Managed Care Follow Up Specialist

Manager of Compliance Audit

Banking Analyst - Chargeback & Payments Operations

Sr Dispute Correspondence Specialist (REMOTE)

PROJECT SPECIALIST - HEALTHCARE - REMOTE

Dispute Resolution Specialist II

Appeals Specialist (Part C)

Claims Auditor, Managed Care (remote)

CAT Claims Specialist

Escalation Specialist

Dispute Resolution Specialist I, II, III, Senior

Supervisor (Clinical Adjudication) Weekday Evening Shift - Flexible Scheduling (Part C)

Dispute Resolution Specialist

CLIENT SUCCESS MANAGER- HOME HEALTH CODING & QUALITY ASSURANCE

Remote Account Resolution Representative

I want to receive the latest job alert for Dispute Resolution Professional

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected