After completing this unit, learners will be able to: • Identify and explain contractual clauses that govern dispute resolution and payment appeals. • Demonstrate step-by-step understanding of the dispute lifecycle—from initial negotiation to binding arbitration or litigation. • Interpret restrictive clauses (e.g., binding arbitration) and assess their impact on provider rights and recourse. • Apply professional writing standards in drafting payer communications, appeal letters, or dispute summaries. • Evaluate real-world contract scenarios to recommend evidence-based resolution strategies. • Maintain payer relationships through effective negotiation, communication, and ethical conflict management. • Integrate legal and compliance principles into daily contract dispute handling practices.

• Foundational knowledge of Healthcare Reimbursement systems or equivalent experience with payer contracts. • Basic understanding of healthcare reimbursement processes, regulatory frameworks, and contract terms. • Prior exposure to payer contracts, rate negotiation, and legal compliance is recommended.

• Contract Managers and Payer Relations Specialists involved in resolving financial or service disputes. • Revenue Cycle and Reimbursement Analysts who handle payer denials or claim escalations. • Health Administrators and Executives overseeing payer partnerships and contract renewals.