Student Veterans of America Jobs

Welcome to SVA’s jobs portal, your one-stop shop for finding the most up to date source of employment opportunities. We have partnered with the National Labor Exchange to provide you this information. You may be looking for part-time employment to supplement your income while you are in school. You might be looking for an internship to add experience to your resume. And you may be completing your training ready to start a new career. This site has all of those types of jobs.

Here are a few things you should know:
  • This site is mobile friendly. You do not need a log-in or password to access information.
  • Jobs on this site are original and unduplicated and come from three sources: the Federal government, state workforce agency job banks, and corporate career websites. All jobs are vetted to ensure there are no scams, training schemes, or phishing.
  • The site is refreshed daily to remove out-of-date content.
  • The newest jobs are listed first, so use the search features to match your interests. You can look for jobs in a specific geographical location, by title or keyword, or you can use the military crosswalk. You may want to do something different from your military career, but you undoubtedly have skills from that occupation that match to a civilian job.
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Job Information

UCLA Health Provider Dispute Resolution Analyst in Los Angeles, California

Description

Take on a key role within a world-class, award-winning health system. Elevate the operational effectiveness of an award-winning healthcare leader. Take your career in an exciting new direction. You can do all this and more at UCLA Health.

You will be responsible for the accurate analysis and resolution of provider disputes. This will require extensive knowledge of CMS Medicare Advantage regulatory requirements, Department of Financial Responsibility (DOFR) provisions, and internal operation requirements, policies, and procedures. You will:

  • Review and process provider dispute resolutions according to state and federal designated timeframes

  • Research and respond to provider inquiries related to claims payments

  • Research reported issues; adjust claims and determine the root cause of the dispute

  • Draft written responses to providers in a professional manner within required timeliness

  • Ensure the accurate and timely processing of PDR documents

  • Serve as subject matter expertise in evaluating and responding to all provider disputes

  • Analyze complex post-paid healthcare claims

  • Apply in-depth research to determine accuracy and mitigate payment errors

  • Communicate with external and internal providers, both verbally and in writing related to the cases under review

  • Coordinate with other departments as necessary to facilitate resolution of claim related issues. Identify and report claim related claim issues for provider education

Salary Range: $24.28 - $48.04 HourlyQualifications

We're

seeking a self-motivated, detail-oriented, deadline-driven individual with:

  • Five or more years of healthcare claim processing experience in a managed care environment

  • One or more years of experience with provider disputes

  • Experience processing PDR documents

  • Ability to interpret provider contracts and apply them to claims adjudication

  • Computer proficiency with Microsoft Office

  • Strong math, communication, analytical, critical-thinking, and problem-solving skills

  • Knowledge of medical terminology, claim forms, and physician billing coding

  • Ability to read/interpret contracts, standard reference materials, etc.

UCLA Health is a world-renowned health system with

four award-winning hospitals and more than 260 community clinics throughout

Southern California. We're also home to the world-class medical research and

clinical education capabilities of the David Geffen School of Medicine. Through

the efforts of our outstanding people, we have become Los Angeles' trusted provider of exceptional, compassionate patient care.

If you're looking to

experience greater challenge and fulfillment in your career, you can at UCLA Health.

UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.

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