Federal NSA IDR Arbitration

National Medical Reviews, Inc.; United States; Remote; USD 90,000 - 130,000; Full time

Job summary

National Medical Reviews, Inc. (NMR) is seeking highly qualified Arbitrators to serve on its NSA IDR panel.

Arbitrators conduct impartial reviews of payment disputes between providers, facilities, and health plans under the federal IDR process, applying NSA regulations and CMS guidance. The role requires strong analytical and decision-making skills, independence and strict confidentiality, with written determinations that clearly state the rationale and comply with federal timelines.

Qualifications

• JD from an accredited law school and active U.S. license.
• Experience in healthcare reimbursement, compliance, or dispute resolution.
• Strong ability to analyze complex regulatory requirements.
• Excellent written communication and timely decision making.

Responsibilities

• Conduct independent NSA IDR determinations per NSA and regulations.
• Review offers, supporting docs, and regulatory factors.
• Evaluate evidence impartially to set appropriate reimbursements.
• Prepare clear, well-supported written determinations.
• Manage disputes to meet federal timelines.
• Maintain confidentiality of sensitive information.
• Apply policies and conflict-of-interest requirements.
• Communicate case status with stakeholders.

Skills

Legal analysis

Regulatory interpretation

Written communication

Independent judgment

Time management

Confidentiality

Case management software

Education

Juris Doctor (JD)

Active U.S. law license

Tools

Case management software

Job description

National Medical Reviews, Inc. (NMR)

National Medical Reviews, Inc. (NMR) is a URAC-accredited Independent Review Organization with Independent Dispute Resolution (IDR) designation, specializing in the resolution of healthcare disputes and independent reviews. As a certified IDR Entity specializing in the resolution of payment disputes under the No Surprises Act (NSA), NMR provides impartial, evidence-based determinations for disputes between healthcare providers, facilities, air ambulance providers, and health plans in accordance with federal regulations and guidance issued by the Centers for Medicare & Medicaid Services (CMS) and the Departments of Health and Human Services, Labor, and Treasury. NMR is committed to delivering fair, timely, and objective decisions while maintaining the highest standards of integrity, professionalism, and regulatory compliance.

Position Overview

NMR is seeking highly qualified Arbitrators to serve on its NSA IDR panel. Arbitrators are responsible for conducting impartial reviews of payment disputes between healthcare providers, facilities, and health plans under the federal IDR process. The ideal candidate possesses strong analytical and decision-making skills, experience interpreting complex regulatory requirements, and the ability to evaluate evidence objectively. Arbitrators must maintain independence and neutrality while issuing well-reasoned determinations within established federal timelines.

Responsibilities

• Conduct independent dispute resolution determinations in accordance with the NSA, implementing regulations, and applicable federal guidance.
• Review and analyze submitted offers, supporting documentation, and applicable statutory and regulatory factors.
• Evaluate evidence objectively and impartially to determine the appropriate out-of-network reimbursement amount.
• Prepare clear, concise, and well-supported written determinations that articulate the basis for decision-making.
• Manage assigned disputes efficiently to ensure compliance with federal processing and decision timelines.
• Maintain strict confidentiality of sensitive health information, proprietary business information, and dispute materials.
• Apply established policies, procedures, and conflict-of-interest requirements throughout the review process.
• Communicate professionally with internal stakeholders regarding case status, procedural requirements, and dispute outcomes.

Qualifications

• Juris Doctor (JD) degree from an accredited law school required.
• Active license to practice law in at least one U.S. jurisdiction and in good standing.
• Experience in healthcare reimbursement, health insurance operations, healthcare compliance, healthcare law, regulatory affairs, claims adjudication, dispute resolution, arbitration, or related fields.
• Strong understanding of the No Surprises Act, healthcare payment methodologies, and federal healthcare regulations preferred.
• Demonstrated ability to analyze complex documentation and apply regulatory standards consistently and objectively.
• Exceptional written communication skills with the ability to clearly articulate findings and rationale.
• Strong organizational and time-management skills with the ability to manage multiple cases and deadlines concurrently.
• Ability to maintain independence, impartiality, and confidentiality in all aspects of the dispute resolution process.
• Proficiency using web-based case management systems and standard business software applications.

Preferred Qualifications

• Experience participating in arbitration, mediation, independent review, or formal dispute resolution processes.
• Familiarity with commercial health insurance, provider contracting, revenue cycle management, or healthcare payment policy.
• Previous experience reviewing medical billing, reimbursement, or healthcare regulatory disputes.
• Knowledge of CMS regulations and federal healthcare programs.