Independent Dispute Resolution (IDR) Specialist

Job Description

Job Description

A growing medical billing and arbitration company is seeking an experienced, organized, and detail-oriented IDR / Arbitration Specialist to join our growing team.

Candidates MUST have a minimum of 1 year of hands-on experience with Federal No Surprises Act (NSA) IDR arbitrations.

The ideal candidate will have a strong understanding of out-of-network medical claims, insurance reimbursement disputes, and Federal IDR procedures.

Key Responsibilities

• Manage Federal NSA IDR cases from initiation through final determination.
• Prepare and submit Open Negotiation Requests (ONRs).
• Submit arbitration cases through the Federal IDR portal.
• Handle eligibility disputes and respond to requests for additional documentation.
• Review EOBs, reimbursement rates, and supporting claim documentation.
• Prepare detailed arbitration submissions and payment justifications.
• Monitor and maintain strict arbitration deadlines.
• Track arbitration decisions, awards, and outstanding payments.
• Follow up with insurance carriers regarding unpaid arbitration awards.
• Maintain accurate case records and status updates in Smartsheet.
• Assist with New Jersey State IDR cases, including Maximus submissions.
• Collaborate with the billing and appeals departments.

Required Qualifications

• MUST have at least 1 year of direct Federal NSA IDR arbitration experience.
• Experience submitting and managing cases through the Federal IDR portal.
• Strong understanding of Open Negotiations, IDR eligibility, and arbitration deadlines.
• Knowledge of out-of-network medical billing and reimbursement.
• Ability to independently manage multiple arbitration cases.
• Excellent attention to detail and organizational skills.
• Strong written and verbal communication skills.
• Experience with New Jersey State IDR is a plus.

What We're Looking For

We are seeking a dependable, motivated individual who can work independently, manage a high volume of cases, and consistently meet strict deadlines.

Please note: A minimum of 1 year of direct Federal NSA IDR experience is required. General medical billing or appeals experience alone does not satisfy this requirement.

How to Apply

Please submit your resume detailing your experience with Federal NSA IDR arbitrations.
Out-of-Network Revenue Cycle Management | Appeals | Arbitration