Senior Analyst, Pre-Pay Dispute Coding (Remote)

Job description

Job Description Job Summary: Provides lead level expertise in the resolution of complex provider denial disputes and state complaint cases ensuring the claims adhere to correct billing standards and regulations. Job Duties: - Investigates and resolves escalated provider denial dispute cases that require advanced experience and specialized knowledge. Addresses and resolves state complaint cases related to escalated provider denial disputes. - Provides assistance to dispute coders by responding to inquiries accurately and in a timely manner. - Prepares and summarizes trends identified by dispute coders for review by team leadership. - Investigates and resolves escalated dispute cases that require additional experience and expertise. - Identifies and communicates any coding errors or inconsistencies, collaborating with appropriate internal department(s) when necessary, capturing and tracking issues to ensure accurate code editing. - Supports ongoing dispute process improvements and informs leadership of any identified issues. Job Qualifications: REQUIRED QUALIFICATIONS: To all current Molina employees: If you are interested in applying for this position, please apply through the Inter...