Provider Dispute Resolution Specialist
Company: VirtualVocations
Location: Vista
Posted on: May 24, 2025
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Job Description:
A company is looking for a Provider Dispute Resolution
Specialist who will be responsible for reviewing, researching, and
resolving provider disputes in compliance with regulatory
guidelines and internal policies.
Key Responsibilities
Investigate and resolve provider disputes related to denied,
underpaid, or incorrectly processed claims
Utilize EZCap to review claims history, adjudication data, and
notes
Document findings and resolutions according to compliance
standards
Required Qualifications
High school diploma or equivalent; associate or bachelor's degree
is a plus
1-2 years of provider dispute resolution experience in healthcare
or claims processing environments
Hands-on experience with EZCap is strongly preferred
Familiarity with Medi-Cal and Commercial insurance claims
Ability to manage multiple tasks and meet deadlines
Keywords: VirtualVocations, Upland , Provider Dispute Resolution Specialist, Other , Vista, California
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