PDR INTAKE COORDINATOR NEEDED ASAP!
Location: Los Angeles
Posted on: October 26, 2024
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Job Description:
Well known Health Care Company is looking for a Provider Dispute
Resolution (PDR) Intake Coordinator. In this role, you will support
the PDR unit in acknowledging Provider Dispute Resolution requests
sent by providers and maintains compliance as regulated by CMS and
DMHC guidelines. Coordinator will research Provider Disputes
submitted by contracted and non-contracted providers to identify
original paid or underpaid claims in MHC and other systems.
Responsibilities include (not limited to):
Processing of incoming PDR?s via certified mail, USPS, faxes,
emails and all other sources of delivery methods. You will sort
through PDR receipts to identify and correctly route provider
issues to the appropriate departments. You will research and
identify using MHC to identify original claim being disputed by the
Provider using the Provider dispute resolution process. Also
responsible for keying PDR?s into SSO system. You will mail out
correspondence letters to provider. You will take calls that are
forwarded from the member service department and claims provider
call center regarding Provider dispute resolution inquiries. You
will follow up with provider regarding requested information and
waiver of liability request forms that are sent on Medicare
members. Email resume as a word attachment to Paris Goldfarb. We
are an equal employment opportunity employer and will consider all
qualified candidates without regard to disability or protected
veteran status.
Keywords: , Rosemead , PDR INTAKE COORDINATOR NEEDED ASAP!, Administration, Clerical , Los Angeles, California
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