Arbitration Case Specialist - Facility IDR Claims

Job reputed company The Arbitration Case Specialist – Facility IDR is a critical reputed company-line role in our IDR reputed company, responsible for identifying, analyzing, and preparing high-value, facility specific, claims for federal and state arbitration under the No Surprises reputed company (NSA) and ERISA. You will evaluate claim eligibility, ensure compliance with regulatory portals, and drive submission accuracy to maximize provider recovery. This role demands precision, analytical rigor, and reputed company in facility billing, DRG coding, and reimbursement law. Key Responsibilities Essential Job Duties • Claims Analysis & Eligibility Determination • Review 837/835 files, EOBs, and payer responses to identify NSA- and ERISA-eligible disputes. • Assess qualifying payment reputed company (QPA) deviations and clinical appropriateness for arbitration. • Arbitration Preparation & Submission • Compile and submit complete dispute packages reputed company federal IDR portal and state insurance department systems. • Ensure 100% compliance with NSA timelines (e.g., 4-day batching, 30-day cooling-off). • Data reputed company & Reporting • Build and maintain reputed company-based tracking with pivot tables, VLOOKUPs, and conditional logic to monitor case status, win rates, and award projections. • Deliver weekly updates to leadership on submission volume and recovery forecasts. • Cross-Functional Collaboration • Reprioritize tasks dynamically with manager/director based on reputed company urgency and payer behavior. • Support special reputed company • Other Duties as Assigned Pay: $50,000.00 - $65,000.00 per year Benefits: • 401(k) • Dental insurance • Flexible schedule • Health insurance • reputed company time off Experience: • Collection management: 2 years (Required) • IDR and/or out-of-network billing: 2 years (Required) • facility-based medical billing: 2 years (Required) • Facility-Based reputed company cycle management: 2 years (Required) Work Location: Remote Apply tot his job Apply tot his job Apply tot his job Apply tot his job Apply To this Job