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Senior Dispute Resolution Specialist Jobs (NOW HIRING)

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RemX is seeking a detail-oriented Healthcare Reimbursement & Dispute Resolution Specialist for a growing healthcare organization. This is an excellent opportunity for individuals with experience in ...

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Senior Dispute Resolution Specialist information

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$34K

$70.3K

$114.5K

How much do senior dispute resolution specialist jobs pay per year?

As of Aug 23, 2026, the average yearly pay for senior dispute resolution specialist in the United States is $70,345.00, according to ZipRecruiter salary data. Most workers in this role earn between $50,000.00 and $86,500.00 per year, depending on experience, location, and employer.

What is the difference between Senior Dispute Resolution Specialist vs Dispute Resolution Analyst?

AspectSenior Dispute Resolution SpecialistDispute Resolution Analyst
CredentialsTypically requires advanced certifications and experienceOften entry to mid-level, with relevant certifications preferred
Work EnvironmentHandles complex cases, often in leadership roles within legal or corporate settingsSupports dispute processes, conducts research, and assists senior staff
Employer & IndustryFinancial services, legal firms, corporate complianceLegal, finance, and customer service sectors

The Senior Dispute Resolution Specialist generally manages complex disputes, leveraging extensive experience and certifications, while the Dispute Resolution Analyst supports case analysis and research. The specialist often leads cases, whereas the analyst provides essential support within the dispute resolution process.

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What cities are hiring for Senior Dispute Resolution Specialist jobs?

Cities with the most Senior Dispute Resolution Specialist job openings:

What are the most commonly searched types of Dispute Resolution Specialist jobs?

The most popular types of Dispute Resolution Specialist jobs are:

What states have the most Senior Dispute Resolution Specialist jobs?

States with the most job openings for Senior Dispute Resolution Specialist jobs include:

Infographic showing various Senior Dispute Resolution Specialist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 12% Part Time, and 2% Contract. Highlights an 79% Physical, 2% Hybrid, and 19% Remote job distribution, with an average salary of $70,345 per year, or $33.8 per hour.

PROVIDER DISPUTE RESOLUTION SPECIALIST

NORTH EAST MEDICAL SERVICES

Burlingame, CA • On-site

$42.79 - $48.75/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 19 days ago


Job description

The MSO department seeks a PDR Specialist with strong verbal and written communication skills to handle provider disputes and appeals related to claims payments. This role involves researching, evaluating, and resolving claims disputes in line with regulations, policies, and industry standards. The specialist will also conduct root cause analyses, process claims readjustments, support system improvements, and manage the overpayment recoupment process.

The role requires an individual with strong analytic skills and critical thinking/problem solving skills. This individual must also have exceptional interpersonal skills to build and maintain positive working relationships.

Key Responsibilities:

  • Review and resolve provider payment disputes and appeals for Medi-Cal Managed Care, Medicare Advantage, and PACE programs.
  • Respond to complex provider inquiries regarding claims adjudication and payments.
  • Ensure timely and accurate resolutions to disputes per regulatory guidelines.
  • Maintain accurate records of dispute resolutions and update tracking systems.
  • Identify and correct claims payment errors, process adjustments, and handle provider overpayment refunds.
  • Analyze payment trends and escalate training or process improvement needs.
  • Assist with health plan audits and other projects related to provider dispute process as required.
  • Identify system configuration issues and report for resolution.
  • Performs other job duties as required by manager/supervisor and NEMS Management Team.
  • Bachelor’s degree preferred. Associate degree with relevant experience may be considered.
  • Minimum five years of experience in medical claims adjudication required.
  • Strong analytical, problem-solving, and communication (written & verbal) skills.
  • Knowledge of Medi-Cal & Medicare Advantage claims reimbursement and dispute resolution.
  • Familiarity with healthcare compliance (HIPAA, CMS, DHCS, AB1455).
  • Understanding of medical terminology, coding, and claim forms.
  • Detail-oriented with strong organizational and time management skills.
  • Proficiency in PC-based software and database management.

LANGUAGE:

  • Must be able to fluently speak, read and write English.
  • Fluent in other languages are an asset.

STATUS:

  • This is an FLSA Non-Exempt position.
  • This is not an OSHA high-risk position.
  • This is a full-time position.


NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k).