[Remote] NSA IDR Dispute Specialist

Note: The job is a remote job and is open to candidates in USA. Reliant Health Partners is an innovative medical claims repricing service provider, helping employers achieve maximum health plan savings with minimum noise. As an IDR dispute specialist, you are responsible for managing all IDR disputes, documenting the process, and communicating with various teams to ensure timely resolution of disputes. Responsibilities • Monitor, manage and add appeals to the queue. • Monitor and manage all IDR emails from CMS, initiating provider, finance, compliance team and client. • Research and communicate via CMS portal for the initial dispute within 3 business days from the received date. • Research and communicate with the finance team for IDRe/admin payment within 3-5 business from the received date. • Research and communicate with the compliance team to request an offer & supporting documents for the IDRe within 3-5 days business days from the received date. • Document & upload IDR documents in queue. • Compile folders for individual disputes to catalog documents and prep for offer & supporting documents from our compliance team. • Communicate IDR rulings with NSA Manager & compliance team. • Process IDR rulings and if needed, send adjustment to the client. • Document all IDR processes in manual. Highlight special scenarios and maintain examples for complex disputes and or rulings. • Maintain acceptable levels of production including but limited to turn around time standards as mandated by the regulation(s). • Adhere to client specific and Reliant protocols, scripts, and other requirements. • Perform other job-related duties and special projects as required. • Other duties as assigned. Skills • 2-3 years of relevant job experience – No Surprises Act, negotiations and or medical claim processing. • Experience conducting outreach to clients & providers via email or other means of communication. • Experience understanding company critical behaviors and compliance requirements. • Broad healthcare policy and payment understanding. • Experience with claims workflow tools or systems. Benefits • Comprehensive medical, dental, vision, and life insurance coverage • 401(k) retirement plan with employer match • Health Savings Account (HSA) & Flexible Spending Accounts (FSAs) • Paid time off (PTO) and disability leave • Employee Assistance Program (EAP) Company Overview • Reliant Health Partners is a medical bolthires containment and specialty bill review company. It was founded in 2010, and is headquartered in Collierville, Tennessee, USA, with a workforce of 11-50 employees. Its website is Apply tot his job Apply tot his job