Lead Analyst, Independent Dispute Resolution

This is a fully remote position, open to applicants in Alabama, +18 more states.

📋 Description

• Manage the complete IDR workflow for designated clients.

• Ensure all submissions are accurate, timely, and compliant with regulations.

• Act as the point of escalation for intricate eligibility assessments, payer communications, and arbitration documentation.

• Review and verify analyst submissions for correctness and compliance with federal and state IDR standards.

• Track and report on operational KPIs, such as acceptance rates, win/loss ratios, and turnaround times.

• Oversee complex reconciliation activities involving payments, adjustments, and returned accounts.

• Work alongside Analytics and Product teams to enhance reporting, automate workflows, and validate data.

• Analyze trends in payer behavior, eligibility, and outcomes to guide team strategies and boost win rates.

• Provide mentorship and guidance to IDR Analysts on challenging cases, technical precision, and task prioritization.

• Serve as a liaison between analysts and management for operational inquiries, best practices, and feedback.

⛳️ Requirements

• Bachelor’s degree in Healthcare Administration, Business, or a related field (or equivalent experience).

• A minimum of 5 years of experience in healthcare revenue cycle management or managing payer disputes.

• At least 2 years of experience in IDR or OON operations.

• Extensive knowledge of No Surprises Act requirements, payer submission protocols, and arbitration procedures.

• Advanced skills in Excel and familiarity with healthcare data systems (Epic, Athena, etc.).

• Excellent analytical, organizational, and communication abilities.

• Demonstrated capability to juggle multiple priorities effectively.

• A valid government-issued photo ID is required during screening and/or interviews.

• Priority will be given to applicants residing in the following states: AL, AR, AZ, FL, GA, ID, IN, KS, ME, MI, MO, MS, NC, NM, OK, PA, SC, TN, TX, VA, WI, WV.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Life insurance.

• Short-term disability.

• Long-term disability.

• Paid holidays.

• 401(k).

• Generous PTO policy.

• Remote work options.

• Dedicated, distraction-free workspace at home.