E0005
Located in Meridian, ID
Pay: $20-27/hr,
Job Full Description
Express Employment is seeking an independent dispute resolution and open negotiation case specialist for a health insurance provider. Job duties include:
- Managing incoming open negotiation requests and ensuring timely initiation within CMS guidelines
- Organizing and maintaining provider and member documentation in spreadsheet and shared drives
- Tracking and updating case statuses
- Reviewing claims for qualification and QPA accuracy
- Coordinating with home plans
- Preparing Letters of Agreement (LOAs) and processing claim adjustments when applicable
- Receiving and documenting IDR initiation forms, entity selections, and fee notices
- Submitting timely responses, offers, and payments per CMS timelines
- Tracking dispute outcomes, including payment determinations and refunds
- Maintaining accurate records and updating spreadsheets with dispute status and resolution
- Submitting claim adjustments and closing disputes
Requirements:
- 2+ years of experience in healthcare operations, provider relations, regulatory compliance, and/or provider-payer dispute workflows
- Familiarity with CMS IDR processes and the No Surprises Act preferred
- Strong attention to detail, highly organized, and ability to manage complex documentation workflows
- Proficiency in Microsoft Excel, Outlook, and shared drive systems
Other details:
- Position is onsite in Meridian, with potential hybrid after training
- Schedule is Monday-Friday, 8am-5pm
- Pay rate is $20-27/hr. DOE
- Position is a one-year contract
If you are interested in and qualified for this opportunity, please call or text “IDR” to (208) 343-7552 and/or fill out the online application. Express Employment is an Equal Opportunity Employer offering benefits from the first day of employment, including medical, vision, dental, life insurance, 401(k), referral bonuses, and direct deposit.
Boise, ID
2321
9390 West Overland Road
Boise, ID 83709
Apply Now Email Us