Dispute Resolution Reviewer (Medical Coding & Insurance Claims Expert)

Akkodis; Springfield (MA); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare compliance organization is seeking a Dispute Resolution Reviewer for a remote contract-to-hire opportunity. The role involves reviewing medical coding and billing issues, resolving disputes related to insurance claims, and utilizing coding knowledge to make recommendations. Ideal candidates will have relevant medical coding experience and the ability to work in a structured, fast-paced environment.

Qualifications

• 1+ year of experience in medical coding or billing required.
• Experience handling insurance claims from the payer side.
• Ability to read and interpret EOBs and remark codes.

Responsibilities

• Review Explanation of Benefits (EOBs) and resolve disputes.
• Research service codes and coverage policies.
• Handle 24+ insurance dispute cases per day.

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.

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
• San Francisco Fair Chance Ordinance

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