The Medical Billing / NSA / IDR Specialist processes out-of-network emergency claims under the No Surprises Act (NSA), with a primary focus on the Independent Dispute Resolution (IDR) process. This role is responsible for reviewing claims, preparing required documentation, and submitting cases accurately and on time to support appropriate reimbursement.
Key duties include submitting open negotiations and IDR cases, following up with insurance carriers, mediators, and IDR entities, and resolving outstanding issues such as underpayments, missing information, or payment delays. The specialist maintains accurate records, updates internal tracking systems, and ensures that all work adheres to federal guidelines and internal procedures.
The NSA/IDR Specialist is expected to communicate effectively, support team workflows, and help identify training needs, while consistently meeting daily, weekly, and monthly productivity goals.
- High school diploma or GED
- Minimum 1 year of experience with insurance follow-up and NSA/IDR process
- Understanding of in-network vs. out-of-network facility and physician claims
- Ability to read and interpret Explanation of Benefits (EOBs)
- Experience with commercial payers such as UHC, Cigna, Aetna, and BCBS preferred
- Strong written and verbal communication skills
- Comfortable handling payer phone calls and follow-ups
- Basic proficiency with billing systems and Microsoft Excel/Word
- Ability to work independently and meet deadlines in a high-volume environment
- Health benefits start on the first of the month after hire
- Medical, dental, and vision plans with sliding-scale premiums
- 100% coverage for preventive health services
- HSA and FSA options available
- Company-paid life insurance and long-term disability
- 401(k) with contributions starting after 30 days
- 100% match on the first 4%
- Full vesting after 3 years
- Employee discounts on travel, fitness, shopping, and more
- Paid time off
- Paid holidays
Location
Houston, Texas, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
5 months ago