Remote Healthcare IDR Specialist

Imagine360, LLC; United States; Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

Multiple Health plan options

Company paid employee premiums for dis

Parental Leave Policy

20 days PTO to start

10 Paid Holidays

Tuition reimbursement

401k Company contribution

Short & Long term Disability plus Life

Professional development initiatives

Diversity & inclusion initiatives

Job summary

Imagine360, LLC is seeking a Dispute Resolution Specialist to join the team. The role focuses on research, strategy, communication, and Independent Dispute Resolution (IDR), coordinating with leadership to achieve efficient outcomes.

The position oversees intake, processing and coordination of materials as regulated by federal or state law. Position is 100% remote with duties including analysis of disputed health plan positions, due diligence for arbitration packages, and collaboration across

Qualifications

• Minimum 1 year of experience in healthcare operations relating to the No Surprises Act or Independent Dispute Resolution.
• Proven ability to manage multiple priorities and meet deadlines.
• Strong organizational and analytical abilities.
• Ability to learn quickly and work independently.
• Proficient in MS Word, Excel and Outlook.

Responsibilities

• Prepare written analyses of disputed health plan positions and persuasively document arguments supporting client positions in arbitration packages pursuant to federal regulations.
• Conduct due diligence to assist with the analysis and preparation of arbitration packages.
• Work with other departments to develop or obtain information necessary for the submission of IDR packages.
• Review and analyze clinical information along with documents submitted by providers of moderate to high complexity.
• Meet federal filing deadlines and turnaround times.
• Maintain detailed and accurate records.
• Maintain department productivity and quality standards.
• Collaborate, coordinate, and communicate across disciplines and departments.
• Ensure compliance with HIPAA regulations and requirements.
• Any other duties or responsibilities related to IDR that may be otherwise required or assigned as necessary.

Skills

Organizational skills

Analytical skills

Independent decision-making

Problem solving

Time management

Microsoft Word

Microsoft Excel

Outlook

Written and verbal communication

Job description

Imagine360, LLC is seeking a Dispute Resolution Specialist to join the team. The role focuses on research, strategy, communication, and Independent Dispute Resolution (IDR), coordinating with leadership to achieve efficient outcomes.

The position oversees intake, processing and coordination of materials as regulated by federal or state law. Position is 100% remote with duties including analysis of disputed health plan positions, due diligence for arbitration packages, and collaboration across