Remote Reports to: Claims Supervisor Position Summary: TheClaims Quality Auditor plays a key role ... dispute resolution. The ideal candidatehas hands on experience withEZCap,auditing claims, analyzing ...
Remote Reports to: Claims Supervisor Position Summary: TheClaims Quality Auditor plays a key role ... dispute resolution. The ideal candidatehas hands on experience withEZCap,auditing claims, analyzing ...
Claims Quality Auditor - Remote
Tampa, FL · On-site +1
Remote Reports to: Claims Supervisor Position Summary: The Claims Quality Auditor plays a key role ... dispute resolution efficiency. * Conduct thorough root cause analyses on high-impact errors or ...
Claims Quality Auditor - Remote
Tampa, FL · On-site +1
Remote Reports to: Claims Supervisor Position Summary: The Claims Quality Auditor plays a key role ... dispute resolution efficiency. * Conduct thorough root cause analyses on high-impact errors or ...
... dispute resolution including representation in various types of claims, controversies and ... This position is also open to partner candidates that will work remote but are based in Florida.
... dispute resolution including representation in various types of claims, controversies and ... This position is also open to partner candidates that will work remote but are based in Florida.
Attorney - Employment and Labor Partner (remote) (Miami, FL; Orlando, FL; ...)
Miami, FL · On-site +1
... dispute resolution including representation in various types of claims, controversies and ... This position is also open to partner candidates that will work remote but are based in Florida.
Attorney - Employment and Labor Partner (remote) (Miami, FL; Orlando, FL; ...)
Miami, FL · On-site +1
... dispute resolution including representation in various types of claims, controversies and ... This position is also open to partner candidates that will work remote but are based in Florida.
340B - Lawyer/Paralegal
Miami, FL · Remote
$67K - $90K/yr
Key Responsibilities: - Provide legal analysis and guidance on 340B program compliance, including ... dispute resolution processes. Why Join Us? - Fully remote position with flexible hours ...
340B - Lawyer/Paralegal
Miami, FL · Remote
$67K - $90K/yr
Key Responsibilities: - Provide legal analysis and guidance on 340B program compliance, including ... dispute resolution processes. Why Join Us? - Fully remote position with flexible hours ...
Responsible for the receipt, review, and oversight of alternative dispute resolution assignments requiring strategic analysis and response. * Manage an inventory of litigated claims in accordance ...
Responsible for the receipt, review, and oversight of alternative dispute resolution assignments requiring strategic analysis and response. * Manage an inventory of litigated claims in accordance ...
Claims Examiner - Remote
Tampa, FL · On-site +1
Experience processing Provider Dispute Resolution (PDR), appeals, reconsiderations, or claim ... Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive ...
Claims Examiner - Remote
Tampa, FL · On-site +1
Experience processing Provider Dispute Resolution (PDR), appeals, reconsiderations, or claim ... Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive ...
Claims Examiner - Remote
Tampa, FL · Remote
Experience processing Provider Dispute Resolution (PDR), appeals, reconsiderations, or claim ... Remote work offered * Equipment provided * Paid trainingto set you up for success * Comprehensive ...
Claims Examiner - Remote
Tampa, FL · Remote
Experience processing Provider Dispute Resolution (PDR), appeals, reconsiderations, or claim ... Remote work offered * Equipment provided * Paid trainingto set you up for success * Comprehensive ...
Attorney-Workers Compensation Partner
Miami, FL · On-site +1
... assessment and dispute resolution including representation in various types of claims ... This position can be remote. THE QUALIFICATIONS The ideal candidate is licensed to practice in ...
Attorney-Workers Compensation Partner
Miami, FL · On-site +1
... assessment and dispute resolution including representation in various types of claims ... This position can be remote. THE QUALIFICATIONS The ideal candidate is licensed to practice in ...
The candidate will primarily be involved in construction dispute resolution, claims preparation and analysis, forensic accounting, cost analysis, and providing project controls and contract ...
The candidate will primarily be involved in construction dispute resolution, claims preparation and analysis, forensic accounting, cost analysis, and providing project controls and contract ...
The candidate will primarily be involved in construction dispute resolution, claims preparation and analysis, forensic accounting, cost analysis, and providing project controls and contract ...
The candidate will primarily be involved in construction dispute resolution, claims preparation and analysis, forensic accounting, cost analysis, and providing project controls and contract ...
... dispute resolution including representation in various types of claims, controversies and ... This position can be nearly fully remote. THE QUALIFICATIONS Qualified candidates will have at ...
... dispute resolution including representation in various types of claims, controversies and ... This position can be nearly fully remote. THE QUALIFICATIONS Qualified candidates will have at ...
... dispute resolution including representation in various types of claims, controversies and ... This position can be nearly fully remote. THE QUALIFICATIONS Qualified candidates will have at ...
... dispute resolution including representation in various types of claims, controversies and ... This position can be nearly fully remote. THE QUALIFICATIONS Qualified candidates will have at ...
Card Fraud Specialist
Jacksonville, FL · Remote
$26/hr
Nymbus is a remote-first company. Occasional travel may be required for client engagements, team ... Familiarity with Visa and Mastercard dispute resolution rules and chargeback processes.
Quick apply
Card Fraud Specialist
Jacksonville, FL · Remote
$26/hr
Nymbus is a remote-first company. Occasional travel may be required for client engagements, team ... Familiarity with Visa and Mastercard dispute resolution rules and chargeback processes.
Tax Resolution Specialist
Jacksonville, FL · Remote
$110K - $135K/yr
Remote | $80,000-$130,000 DOE | Full-Time URGENT OPPORTUNITY - IMMEDIATE FILL If you have been ... Analyze complex tax liabilities and develop tailored resolution strategies • Advise clients on ...
Quick apply
Tax Resolution Specialist
Jacksonville, FL · Remote
$110K - $135K/yr
Remote | $80,000-$130,000 DOE | Full-Time URGENT OPPORTUNITY - IMMEDIATE FILL If you have been ... Analyze complex tax liabilities and develop tailored resolution strategies • Advise clients on ...
... dispute resolution including representation in various types of claims, controversies and ... This position offers the potential for a remote arrangement. Goldberg Segalla is one of the premier ...
... dispute resolution including representation in various types of claims, controversies and ... This position offers the potential for a remote arrangement. Goldberg Segalla is one of the premier ...
Sr. Auto Adjuster
Tampa, FL · On-site +1
$46K - $61K/yr
USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Dispute resolution experience: Liability Investigation/Comparative Negligence, Unrelated Prior ...
Sr. Auto Adjuster
Tampa, FL · On-site +1
$46K - $61K/yr
USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Dispute resolution experience: Liability Investigation/Comparative Negligence, Unrelated Prior ...
Sr. Auto Adjuster
Tampa, FL · On-site +1
$46K - $61K/yr
USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Dispute resolution experience: Liability Investigation/Comparative Negligence, Unrelated Prior ...
Sr. Auto Adjuster
Tampa, FL · On-site +1
$46K - $61K/yr
USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Dispute resolution experience: Liability Investigation/Comparative Negligence, Unrelated Prior ...
Sr. Auto Adjuster
Tampa, FL · On-site +1
$46K - $61K/yr
USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Dispute resolution experience: Liability Investigation/Comparative Negligence, Unrelated Prior ...
Sr. Auto Adjuster
Tampa, FL · On-site +1
$46K - $61K/yr
USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Dispute resolution experience: Liability Investigation/Comparative Negligence, Unrelated Prior ...
WBL operates with a fully remote, multinational workforce and an experienced executive leadership ... Provide guidance on dispute resolution, settlements, and enforcement matters as needed. * Ensure ...
WBL operates with a fully remote, multinational workforce and an experienced executive leadership ... Provide guidance on dispute resolution, settlements, and enforcement matters as needed. * Ensure ...
Remote Dispute Resolution Analyst information
What is the difference between Remote Dispute Resolution Analyst vs Customer Service Representative?
| Aspect | Remote Dispute Resolution Analyst | Customer Service Representative |
|---|---|---|
| Credentials | Typically requires conflict resolution, negotiation, or legal certifications | Usually requires high school diploma or equivalent, customer service training |
| Work Environment | Remote, often in legal, financial, or e-commerce sectors | Remote or on-site, in retail, telecom, or service industries |
| Employer & Industry | Financial institutions, e-commerce companies, legal firms | Retail stores, telecom providers, service companies |
The Remote Dispute Resolution Analyst focuses on resolving conflicts through negotiation and legal knowledge, often in specialized industries. Customer Service Representatives handle general customer inquiries and support. While both roles may work remotely, the Analyst role requires specific dispute resolution skills and certifications, making it more specialized than the Customer Service Representative position.
What are popular job titles related to Remote Dispute Resolution Analyst jobs in Florida? For Remote Dispute Resolution Analyst jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Remote Dispute Resolution Analyst jobs in Florida look for? The top searched job categories for Remote Dispute Resolution Analyst jobs in Florida are:
What cities in Florida are hiring for Remote Dispute Resolution Analyst jobs? Cities in Florida with the most Remote Dispute Resolution Analyst job openings:
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 12 days ago
Job description
Claims Quality Auditor| Remote
Job Type: Full time
Work Setup: Remote
Reports to: Claims Supervisor
Position Summary:
TheClaims Quality Auditor plays a key role in ensuring the accuracy, compliance, and effectiveness of claims processing and provider dispute resolution. The ideal candidatehas hands on experience withEZCap,auditing claims, analyzing dispute claims and evaluating internal policies and regulatory requirements, with a particular focus on Medi-Cal and commercial health plans.This role is responsible to partners closely with cross-functional teams to drive continuous improvement and operational excellence.
Key Duties:
- Perform detailed audits of denied, underpaid, and processed claims using EZCap to assess accuracy and compliance with provider contracts and regulatory guidelines.
- Analyze provider disputes for patterns or recurring issues.
- Identify root causes and work with relevant teams to implement corrective actions and process improvements.
- Develop and track performance related to claims accuracy, turnaround time, and dispute resolution efficiency.
- Conduct thorough root cause analyses on high-impact errors or escalations.
- Support training initiatives by identifying knowledge gaps and assisting in the development of updated procedures and documentation based on audit results.
- Ensure all reviewed processes align with applicable regulatory requirements. Participate in internal and external audits as needed.
Qualifications:
- High school diploma or equivalent
- At least 3-5 years of Quality Analyst in healthcare,TPA, or health plan settings/ healthcare claims or in a claims processing/adjudication environment
- Hands-on experience with EZCap (strongly preferred)
- Familiarity with Medi-Cal and Commercial insurance claim
- Strong analytical and problem-solving skills
- Excellent verbal and written communication
- Attention to detail in documentation and compliance
- Ability to manage multiple tasks and meet deadlines
- Experience with other claim adjudication platforms and provider systems.
- Familiarity with DHCS, DMHC, CMS dispute handling regulations.
What We Offer
- Remote work offered
- Equipment provided
- Paid training to set you up for success
- Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)
- Paid Time Off (PTO)
- 7 paid holidays
- A supportive team and a company that values internal growth
COMPANY OVERVIEW:
Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans' members and providers.
The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans' members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.
Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.