We are an established out-of-network medical billing company located in New Hyde Park, Long Island, seeking an Independent Dispute Resolution Specialist to provide support to the Federal No Surprise Act Department. This position will play a crucial role in providing support to the department by analyzing healthcare claims and managing the IDR process. This position requires strong analytical skills, meticulous attention to detail and effective communication to ensure timely and accurate claim resolution.

Key Job Responsibilities:

• Analyze healthcare claims to determine next steps, including negotiation or Independent Dispute Resolution (IDR)
• Perform daily audits to identify zero-dollar payments, negative balances, or other discrepancies, demonstrating strong analytical skills and attention to detail
• Resolve outstanding claim issues promptly, maintaining accurate records of all actions taken
• Monitor and manage a busy inbox to ensure timely responses, proper routing of inquiries, and that no items are overlooked
• Collaborate with team members to balance workloads and support timely handling of negotiation and IDR processes
• Maintain clear and organized documentation to support compliance and reporting needs
• Contribute ideas to improve workflows, reduce manual tasks, and enhance overall efficiency

Qualifications:

• Prior experience in healthcare claims processing, medical billing, or related fields
• Out of network billing with arbitration experience is helpful
• Strong analytical skills with a high level of accuracy and attention to detail
• Ability to manage multiple priorities and a high-volume workload
• Ability to learn various software platforms and navigate 
• Excellent written and verbal communication skills
• Proficiency in Microsoft Office applications, particularly Excel and Outlook

Benefits:

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