Location: Los Angeles, CA

Schedule: Full Time / Hours between 8am & 5pm.

Pay: $55.80 - $67.31 - Depending on Experience

Job Type: Temporary Assignment

Job Summary:

The Claims Director of Provider Disputes and Resolution has overall responsibility and accountability for all aspects of the claims operation for all Provider Disputes, provider projects, as well as provider refund recoveries. Within this role, the Director will ensure to meet regulatory compliance as well as company objectives as they relate to the resolution of the provider issue.

Key Responsibilities:

 The Director is responsible for leading and supporting each unit while being accountable for performance management, quality improvements and operational accuracy. The Director will leverage experience and integrate various components of cross-functional business decisions to continuously improve claims’ processes and procedures. This position will participate in various forums, company initiatives, and other internal/external workgroups to support Claims integrity. Directs all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.

Work Environment:

 Work is in an office environment, climate controlled through central air conditioning.

Required Skills and Abilities:

• Strong computer skills, proficiency in Microsoft Office programs-MS Word, Excel, and Power Point.


• Knowledge of healthcare reimbursement and billing procedures, CPT and ICD-10 coding, and medical terminology


• Ability to plan, prioritize and schedule multiple work assignments; high degree of organization and time management skills


• Through knowledge of Managed Care regulations and compliance guidelines.


• Ability to audit and conduct performance evaluations of department and staff