Independent Dispute Resolution (IDR) Program Manager
Job Description
Position Overview
We are seeking an experienced Independent Dispute Resolution (IDR) Program Manager to oversee our IDR process under the No Surprises Act (NSA). While a third-party vendor handles dispute submissions, this role serves as the internal owner of the program—ensuring appropriate claims are identified, supported, and strategically managed to maximize reimbursement outcomes.
This position requires strong knowledge of the NSA, payer reimbursement trends, and revenue cycle operations.
Key Responsibilities
- Serve as the internal lead for all IDR activities
- Partner with third-party vendor to ensure timely and compliant filings
- Review and approve claims submitted for IDR consideration
- Analyze payer offers and recommend strategic payment positions
- Monitor dispute outcomes, financial impact, and payer trends
- Maintain compliance with federal and state surprise billing regulations
- Develop reports and dashboards for leadership review
Qualifications
- Minimum 5 years of IDR case management experience
- Prior experience in medical billing or revenue cycle leadership required
- Strong understanding of the No Surprise Act
- Excellent analytical, communication, and organizational skills
- Experience with EHR and billing systems
- Anesthesia billing experience preferred
Education
- High school diploma required
- Associate’s or Bachelor’s degree in Healthcare Administration, Business, or related field preferred