We are a leading out-of-network medical revenue cycle management company specializing in providing comprehensive support to out-of-network healthcare providers. Our services include claims processing, arbitration support, and navigating complex regulatory frameworks, such as the No Surprises Act.

We are seeking an experienced Independent Dispute Resolution (IDR) Director to oversee and manage our arbitration processes, ensure compliance with federal and state regulations, and contribute to our claims processing operations.

Key Responsibilities:

1. Independent Dispute Resolution Management
- Lead and oversee all IDR activities under the No Surprises Act for out-of-network claims.
- Utilize proprietary arbitration software to track, manage, and resolve disputes efficiently for clients.
- Develop and maintain relationships with arbitrators, legal professionals, and other stakeholders.
- Monitor regulatory updates and ensure compliance with arbitration-related laws and guidelines.

2. Claims Processing Collaboration:
- Support and streamline claims processing operations to ensure accurate and timely handling of out-of-network claims.
- Collaborate with the claims team to identify potential arbitration cases and strategize resolutions.

3. Client Engagement:
- Serve as a key point of contact for clients regarding arbitration cases and claims processing.
- Provide expert guidance on dispute resolution processes to clients and internal teams.

4. Process Optimization:
- Analyze and improve workflows for arbitration and claims processing.
- Implement best practices and train staff on arbitration-related software and procedures.

Qualifications:
Education
- Juris Doctor (JD) or Paralegal Certification highly preferred.
- Equivalent experience in healthcare arbitration, revenue cycle management, or legal support will be considered.

Experience:
- Minimum 5+ years of direct experience with out-of-network medical claims, arbitration, or dispute resolution.
- In-depth knowledge of the No Surprises Act and related regulations.
- Familiarity with arbitration platforms and claims processing systems.

Skills:
- Exceptional organizational and analytical abilities.
- Strong understanding of medical billing and coding as it relates to out-of-network claims.
- Excellent communication and negotiation skills.

Benefits:
- Comprehensive health benefits (medical, dental, vision)
- Aflac Insurance Plans
- Profit Sharing Plan
- Paid time off and holidays