Hybrid Provider Dispute Resolution Specialist

UC San Diego; San Diego (CA); Hybrid; USD 90,000 - 110,000; Full time

Job summary

UC San Diego is seeking a claims appeals specialist to own the end-to-end process for medical and provider appeals. You will handle intake, categorization, acknowledgement, resolution, documentation and reporting, coordinating with providers and internal teams.

The role blends onsite work at Greenwich Drive with a hybrid remote schedule in San Diego, CA. The position requires strong data analysis, communication skills, and confidentiality.

Qualifications

• Six years of related experience or a Bachelor's degree plus two years in related work.
• Working knowledge of common computer programs.
• Excellent written and verbal communication.
• Ability to maintain confidentiality and use sound judgment.

Responsibilities

• Responsible for end-to-end claims appeal process including intake, categorization, acknowledgement, resolution, documentation, provider notification, reprocessing, tracking, trending and reporting.
• Collaborate with internal teams and providers to support accurate appeal outcomes.

Skills

Communication

Data analysis

Discretion

Epic Tapestry

Time management

Policy analysis

Education

Bachelor's degree in related area

Job description

UC San Diego is seeking a claims appeals specialist to own the end-to-end process for medical and provider appeals. You will handle intake, categorization, acknowledgement, resolution, documentation and reporting, coordinating with providers and internal teams.

The role blends onsite work at Greenwich Drive with a hybrid remote schedule in San Diego, CA. The position requires strong data analysis, communication skills, and confidentiality.