Supervisor, No Surprise Act (NSA) Operations

Imagine360, LLC; United States; On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Health plan options

Company paid premiums for disability &

Parental Leave Policy

20 days PTO + 10 holidays

Tuition reimbursement

401k company contribution

Disability & life insurance

Professional development

Diversity & inclusion initiatives

Job summary

Imagine360, LLC seeks a Supervisor for NSA Operations to lead a team working with providers and CMS to secure fair payments and efficient issue resolution in IDR. You will refine processes, coach staff, and ensure timely resolution of escalations while ensuring compliance with the No Surprises Act.

The role emphasizes strong communication, regular staff coaching, and close collaboration with management to achieve strategic goals and improve operational efficiency.

Qualifications

• Requires experience in healthcare, health insurance, or customer service.
• Supervisory experience of at least 1 year preferred.
• Familiarity with No Surprises Act and IDR processes is advantageous.

Responsibilities

• Train and develop direct reports per department policies and laws.
• Respond to issues from management, providers, and partners to ensure smooth operations.
• Hire and train new candidates for the team.
• Monitor productivity and provide coaching.
• Handle high-priority and escalated cases.
• Develop and maintain department policies and workflows.

Skills

Caseload management

1-on-1 meetings

Process review

Team coaching

Escalation handling

Documentation

Education

College degree preferred

Bachelor's in business or healthcare administration preferred

Tools

CMS1500 / UB04 forms

Microsoft Office

Job description

The Supervisor, No Surprise Act (NSA) Operations will oversee a team that works directly with providers, third-party organizations, and the Center for Medicare and Medicaid Services (CMS) to ensure fair and reasonable payments, and resolve issues at any level of the process. The process involves claims negotiations and final arbitration in Independent Dispute Resolution (IDR), with several strategic decision points along the way. The Supervisor of Surprise Billing Operations will oversee and refine organizational processes to ensure maximum efficiency and effectiveness.

Supervisory Responsibilities

• Caseload Management.
• Regular 1-on-1 meetings with direct reports.
• Process review and improvement.
• Remote meetings with third party partners and, occasionally, clients.

Duties/Responsibilities:

• Train direct reports in accordance with department policies and procedures, and federal and state laws, to ensure successful NSA negotiations outcomes in IDR.
• Respond to issues, questions, and concerns from management, providers, clients, other partners, and the team, to ensure a smooth member and provider experience.
• Assist in hiring and training new candidates for the team.
• Monitor employee productivity and provide constructive feedback and coaching
• Work escalated, high dollar, and otherwise high-priority cases.
• Delegate special projects and cases as necessary.
• Work with Manager to develop and support successful completion of goals for the team.
• Maintain frequent communication with Manager to ensure efficient operations.
• Manage escalated inquiries from both internal and external parties.
• Develop and maintain department policies and procedures.
• Identify enhancements and changes to workflows to increase effectiveness and productivity.
• Manage and coordinate escalated issue resolutions with both internal and external parties.
• Assist and manage voicemails and phone calls.

Education and Experience:

Required Education:

• College degree preferred but extensive experience without a degree would be considered

Preferred Education:

• Bachelor's degree in business or healthcare administration preferred or related field

Required Experience:

• Minimum of 3 years of healthcare, health insurance, or customer service experience
• Minimum 1 year of supervisory experience

Preferred Experience:

• Experience with the No Surprises Act
• Experience in billing, insurance, healthcare, or legal environments preferred
• Demonstrated success in supervisory role

Skills and Abilities:

• Knowledge and understanding of CMS1500 and UB04 Medical Claim Forms, medical coding, and proficiency in Microsoft Office products desired

Licenses or Certifications:

• None

Physical Requirements:

• Not specified

Imagine360 will make reasonable accommodations to enable applicants to participate in the interview process and other aspects of the hiring process, as well as for current employees, when Human Resources is aware of the need for such accommodations.

I understand that it is my responsibility to contact Human Resources if I need the company to consider making any accommodations to enable me to participate in the hiring process, including the interview, or for any of the job activities, duties or responsibilities included in this Job Description for any of the following reasons:

1. Physical or mental health condition;
2. Pregnancy or childbirth or medical conditions relating to the same; or
3. Religious belief, practice or observance.

What can Imagine360 offer you?

• Multiple Health plan options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Company paid Short & Long term Disability plus Life Insurance
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives

Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.

Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation