Dispute Resolution Reviewer (Medical Coding & Insurance Claims Expert)

Akkodis; Albuquerque (NM); Remote; USD 60,000 - 80,000; Full time

Job summary

Akkodis seeks a Dispute Resolution Reviewer for a remote contract-to-hire position with a healthcare compliance organization. Candidates should have medical coding and insurance claims experience, focusing on resolving disputes and making recommendations based on EOBs. This role demands detail-oriented and tech-savvy individuals with problem-solving skills, offering a chance to leverage expertise in a structured environment.

Qualifications

• 1+ years of experience in medical coding or billing.
• Experience with payer-side insurance claims.
• Ability to interpret EOBs and medical claim language.

Responsibilities

• Review EOBs and appeals under the No Surprises Act.
• Resolve disputes related to out-of-network provider charges.
• Handle 24+ insurance dispute cases daily.

Skills

Detail-oriented

Tech-savvy

Problem-solving

Education

Associate's degree

Tools

Microsoft Excel

Microsoft Word

CMS IDR Portal

Job description

Job Title : Dispute Resolution Reviewer (Medical Coding & Insurance Claims Expert) Location : 100% Remote

Pay Rate : $29 / hour on W-2 (Contract-to-Hire)

Schedule : M–F, 8-hour shifts (Core hours : 9am–3pm ET)

Akkodis is hiring a Dispute Resolution Reviewer for a fully remote contract-to-hire opportunity with a leading healthcare compliance organization. This role is ideal for professionals with medical coding, medical billing, and insurance claims experience at a health plan (e.g., Humana, BCBS, United Healthcare).

If you're detail-oriented, tech-savvy, and enjoy problem-solving in a structured yet fast-paced environment, this role offers a great opportunity to apply your coding and payer-side experience in a meaningful way.

Job 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.
• Use your knowledge of remark codes, CPT codes, and medical service codes to make impartial and binding recommendations.
• Handle 24+ insurance dispute cases per day, documenting decisions accurately in the CMS IDR Portal.

Desired Qualifications :

• 1+ year of experience in medical coding or billing (required).
• Experience handling insurance claims from the payer side (e.g., Humana, BCBS, Aetna).
• Ability to read and interpret EOBs, remark codes, and medical claim language.
• Familiar with dispute resolution, appeals processes, and healthcare regulations.
• Medicaid experience is a plus.
• Comfortable using tools like Microsoft Excel, Word, and the CMS IDR Portal.
• Associate's degree preferred but not required if you have 3+ years of total medical billing / coding experience.
• Has worked as a medical claims analyst, coding specialist, insurance appeals coordinator, or similar.
• Comes from a health plan or third-party administrator (TPA).
• Understands the logic behind coverage decisions and coding disputes—not just how to code, but why codes matter.

If you're a medical billing specialist or insurance coding professional ready to leverage your knowledge in a high-impact, remote role, click APPLY NOW.

Please contact Pratiksha Pandey at 610-979-9170 or [e-mail]

Equal Opportunity Employer / Veterans / Disabled

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

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