Claims Dispute Specialist

LHH Recruitment Solutions; United States; On-site; USD 180,000 - 200,000; Full time

Benefits offered by this job

Equal Opportunity Employer

Job summary

LHH Recruitment Solutions seeks a skilled Dispute Resolution Specialist in the United States to oversee the full NSA/state-law dispute lifecycle, from open negotiations to final outcomes. You will review medical claims for accuracy and eligibility for appeal, prepare supporting documentation, and coordinate with internal teams to support decisions.

The role requires 3+ years of healthcare claims processing, strong analytical and communication skills, and a detail-oriented, strategic mindset to

Qualifications

• 3+ years healthcare claims processing experience.
• Experience with No Surprises Act dispute resolution highly preferred.
• Detail-oriented, analytical, organized and strategic.
• Strong written and verbal communication skills.

Responsibilities

• Manage the full dispute process, including Open Negotiations, Notices of Offer, IDR/arbitration submissions, reimbursement analysis, supporting documentation, written position statements, deadlines and outcomes.
• Review and analyze medical claims to ensure accuracy, compliance, and eligibility for appeal or dispute under the NSA or state law.
• Investigate claim payments and denials by reviewing clinical documentation, insurance payer contracts, and claim history.
• Initiate and manage disputes under the NSA or state law.

Skills

Healthcare claims processing

Job description

RESPONSIBILITIES:

• Manage the full dispute process, including Open Negotiations, Notices of Offer, IDR/arbitration submissions, reimbursement analysis, supporting documentation, written position statements, deadlines and outcomes
• Review and analyze medical claims to ensure accuracy, compliance, and eligibility for appeal or dispute under the NSA or state law
• Investigate claim payments and denials by reviewing clinical documentation, insurance payer contracts, and claim history
• Initiate and manage disputes under the NSA or state law

REQUIREMENTS:

• 3+ years if Healthcare Claims processing experience
• Experience with No Surprises Act dispute resolution Highly preferred
• Detail-oriented, analytical, organized and strategic
• Strong written and verbal communication skills

COMPENSATION:

$180,000 - $200,000 + Bonus

BENEFITS:

Equal Opportunity Employer/Veterans/Disabled

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy