Hybrid Provider Dispute Resolution Specialist

UC San Diego Health; San Diego (CA); Hybrid; USD 63,000 - 92,000; Full time

Job summary

UC San Diego Health is seeking a Provider Dispute Resolution Specialist to oversee end-to-end claims appeals, including intake, categorization, acknowledgement, resolution, reprocessing, tracking and reporting. The position offers a hybrid work arrangement with a blend of on-site at Greenwich Drive (San Diego, CA) and remote work.

Qualifications include six years of related experience or a bachelor’s degree in a related field plus two years of related experience; experience with Epic Tapestry is

Qualifications

• Six (6) years of related experience, education/training, OR a Bachelor’s degree in related area plus two (2) years of related experience/training. Related experience: processing professional and facility claims within Epic Tapestry.
• Working knowledge of common organization- or research-specific and other computer application programs.
• Proficient in communication and interpersonal skills to communicate effectively, both verbally and in writing.
• Proficient in ability to use discretion and maintain all confidentiality.
• Demonstrates ability to use sound judgment in responding to issues and concerns
• Demonstrates ability to analyze, research and synthesize large amounts of data with strong attention to detail.
• Proficient in ability to multi-task with demanding timeframes.
• Working knowledge of applicable policy analysis techniques.

Responsibilities

• Responsible for end-to-end claims appeal process including, but not limited to, claim appeal intake, categorization, acknowledgement, resolution, documentation, provider notification, claim reprocessing, tracking, trending and reporting.

Skills

Communication skills

Confidentiality

Analytical ability

Time management

Education

Bachelor’s degree in related area

Tools

Epic Tapestry

Job description

UC San Diego Health is seeking a Provider Dispute Resolution Specialist to oversee end-to-end claims appeals, including intake, categorization, acknowledgement, resolution, reprocessing, tracking and reporting. The position offers a hybrid work arrangement with a blend of on-site at Greenwich Drive (San Diego, CA) and remote work.

Qualifications include six years of related experience or a bachelor’s degree in a related field plus two years of related experience; experience with Epic Tapestry is