Dispute Resolution Reviewer (Medical Coding & Insurance Claims Expert)

Akkodis; Fresno (CA); Remote; USD 60,000 - 80,000; Full time

Job summary

Akkodis is seeking a Dispute Resolution Reviewer for a remote contract-to-hire role within a healthcare compliance organization. The ideal candidate will have expertise in medical coding and insurance claims, equipped to handle disputes and conduct thorough reviews of Explanation of Benefits (EOBs). This opportunity promises a structured environment where problem-solving skills can shine in managing insurance case disputes effectively.

Qualifications

• 1+ year of experience in medical coding or billing required.
• Experience handling insurance claims from the payer side.
• Familiar with dispute resolution and healthcare regulations.

Responsibilities

• Review EOBs and appeals under the No Surprises Act.
• Resolve disputes related to out-of-network provider charges.
• Research service codes and coverage policies using digital tools.

Skills

Detail-oriented

Problem-solving

Tech-savvy

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