Job Information
Insight Global Certified Edit Dispute Resolution Analyst in Bedminster, New Jersey
Job Description
The Certified Edit Dispute Resolution Analyst will be responsible for researching and auditing
medical records for complex, diverse, multi-specialty provider claims to identify and determine
appropriately coded billed services when compared to the Zelis Claim Edits Product. The Certified
Edit Dispute Resolution Analyst demonstrates an understanding of Zelis edits as an individual
contributor for processing, escalating, routing, and responding to complex incoming Client and
Provider disputes.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com .
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Skills and Requirements
3+ years of relevant experience or equivalent combination of education & work within
healthcare payer or provider.
Certified coder (CCS, CCS-P or CPC), or RN, LPN with coding certification is required.
Knowledge of healthcare reimbursement policies, state and federal regulations and
applicable industry standards.
Knowledge of correct coding and industry standard claim adjudication guidelines and
policies.
Ability to translate coding and adjudication guidelines, policies, and references into edit
policies and rules
Excellent verbal & written communication skills with project management experience
Proficient in Microsoft Office suite (Word, Excel, Power Point etc.) null
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion,sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military oruniformed service member status, or any other status or characteristic protected by applicable laws, regulations, andordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to HR@insightglobal.com.