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Independent Dispute Resolution
2 months ago
Independent Dispute Resolution (IDR) Specialist - Medical Claims
MedHealth Financial is an expanding Anesthesia Billing company, located in Woodbridge, New Jersey seeking a self-motivated, highly organized individual to oversee the Federal Independent Dispute Resolution (No Surprise Act) claim submission and dispute resolution process for a few anesthesiology practices with high out-of-network claims volume.
*Experience with the Federal IDR process from beginning to end is highly desired
If you have experience with the IDR process as a legal, medical administration, or medical billing professional and values service, accuracy, and efficiency, and you want to collaborate with a team that focuses on delivering an extraordinary level of service to anesthesiology practices, MedHealth Financial would like to get to know you
* Direct experience with anesthesiology practice is a plus, but not mandatory.
Job Duties & Responsibilities:
- Obtain Open Negotiation initiated claims data from billing staff and calculate when Federal IDR initiation can begin
- Oversee claims submission on the Federal IDR portal and ensure all necessary documents are available at the time of initiation
- Keep track of all e-mail correspondence from Federal IDR and the IDR entities, paying especially close attention to deadlines
- Prepare emails with IDR fee details to be submitted to clients for payment
- Prepare supporting documentation to be submitted along with offers in the portal
- Keep track of all payment determinations and awards, and make sure payments are received timely
- Keep track of all claims in the 90-day cooling off period, and monitor when they can be submitted on the IDR portal
- Follow up on unprocessed disputes or unpaid claims after determination has been made
- Prepare weekly update emails to clients with IDR activity from the previous week
- Assist with overseeing IDR Representative
- Additional duties and responsibilities as assigned
Required Skills/Abilities:
- Strong professional communication skills verbal and written
- Ability to act with discretion, tact, and professionalism with confidential information
- Advanced MS Excel skills
- Strong understanding of workflows, databases, and related software
- Excellent organizational skills, attention to detail, and accuracy
- Ability to multitask and adhere to deadlines
Education and Experience:
- Experience in Medical Billing specifically Anesthesiology Billing desired
- Knowledge of the No Surprise Act
- Previous Federal IDR process knowledge from beginning to Highly Preferred
- Previous IDR portal experience Highly Preferred
What We Offer
- Flexible hybrid work schedules
- Cross-training for all employees
- Positive work environment
- Competitive salary based on experience
- Positive, supportive, drama free work environment
- Opportunity for growth and advancement
- Potential bonus opportunities
Full Time Employees
- Generous health, dental, & vision insurance
- 15 days PTO your first year of employment
- 8 paid holidays
- 401(k) with employer match
The salary range of $25.00 to $28.00 per hour is commensurate with experience.
This is a direct hire, hybrid position open for an immediate start date in either a part time or full time capacity.
Pay: $25.00 - $28.00 per hour
Expected hours: 25 – 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible schedule
- Health insurance
- Paid time off
- Vision insurance
Schedule:
- Monday to Friday
