The IDR Lead Analyst serves as a senior subject matter expert responsible for analytical oversight, quality assurance, and mentorship for independent dispute resolution submissions under the No Surprises Act and state programs.
In this role, you will partner with the IDR Manager to identify process gaps, optimize workflows, and drive data-informed improvements across client portfolios. You will oversee end-to-end IDR workflows, support complex eligibility and payer communication issues, validate submissions for accuracy, and help improve operational outcomes.
Requirements & Qualifications
Required Qualifications
- Bachelor’s degree in Healthcare Administration, Business, or a related field, or equivalent experience
- 5+ years of experience in healthcare revenue cycle management or payer disputes
- At least 2+ years of experience in IDR or out-of-network operations
- Strong understanding of No Surprises Act requirements, payer submission protocols, and arbitration processes
- Advanced proficiency in Excel and healthcare data systems such as Epic and Athena
- Strong analytical, organizational, and communication skills
- Proven ability to manage multiple priorities
Core Responsibilities
- Oversee end-to-end IDR workflow for assigned clients
- Serve as escalation point for complex eligibility reviews, payer communications, and arbitration documentation
- Audit and validate analyst submissions for accuracy and compliance
- Monitor operational KPIs including acceptance rate, win/loss outcomes, and turnaround time
- Manage reconciliation tasks across payments, adjustments, and returned accounts
- Collaborate with Analytics and Product teams to improve reporting, automation, and data validation
- Identify trends in payer behavior, eligibility, and outcomes
- Mentor and coach IDR Analysts on complex cases, technical accuracy, and prioritization
- Act as a bridge between analysts and management for operational questions and feedback
Benefits & Perks
Benefits
- Medical insurance
- Dental insurance
- Vision insurance
- Life insurance
- Short-term disability
- Long-term disability
- Paid holidays
- 401(k)
- Generous PTO policy
Work Environment
- Remote position
- Dedicated, distraction-free home workspace required
Location
N/A
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
1 month ago
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