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PRINCIPAL RESPONSIBILITIES:
Under the general direction of the Supervisor, Provider Dispute Resolution Supervisor the Provider Dispute Resolution (PDR) Analyst will review, research, and resolve complex and involved provider disputes for contracted as well as non-contracted providers in accordance with state and federal guidelines. Conduct all pertinent research in order to evaluate, respond and close incoming Provider Disputes accurately, timely and in accordance with all established regulatory guidelines. The PDR Analyst will process/adjust the disputed claim(s) accordingly while following department processes, interfacing with internal departments and external resources, as needed.
Principal responsibilities include:
ESSENTIAL FUNCTIONS OF THE JOB
PHYSICAL REQUIREMENTS
Number of Employees Supervised: 0
MINIMUM QUALIFICATIONS:
EDUCATION OR TRAINING EQUIVALENT TO:
MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:
SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):
SALARY RANGE $33.46-$50.20 HOURLY
The Alliance is an equal opportunity employer and makes employment decisions on the basis of qualifications and merit. We strive to have the best qualified person in every job. Our policy prohibits unlawful discrimination based on race, color, creed, gender, religion, veteran status, marital status, registered domestic partner status, age, national origin or ancestry, physical or mental disability, medical condition, genetic characteristic, sexual orientation, gender identity or expression, or any other consideration made unlawful by federal, state, or local laws. M/F/Vets/Disabled.
Full Time
$80k-104k (estimate)
02/08/2024
05/26/2024