Medical Coding Dispute Reviewer

Job Summary

A company is looking for a Dispute Resolution Reviewer (Medical Coding & Insurance Claims Expert).

Key Responsibilities

• Review Explanation of Benefits (EOBs) and appeals from providers and health plans under the No Surprises Act
• Resolve disputes related to out-of-network provider charges by following detailed internal policies
• Research service codes, fees, and coverage policies using digital tools and online databases

Required Qualifications

• 1+ year of experience in medical coding or billing
• Experience handling insurance claims from the payer side
• Ability to read and interpret EOBs, remark codes, and medical claim language
• Familiar with dispute resolution, appeals processes, and healthcare regulations
• Associate's degree preferred but not required with 3+ years of medical billing/coding experience