Claims Dispute Specialist (NSA)

Insight Global's healthcare client is seeking a Claims Dispute Specialist (NSA) to join their growing Revenue Cycle Management team. This individual will play a critical role in managing complex medical claim disputes and arbitration processes related to the No Surprises Act (NSA) and state surprise billing regulations.

The ideal candidate will bring a strong healthcare claims background, exceptional written communication skills, and the ability to manage multiple deadlines in a fast-paced, highly collaborative environment. This position offers the opportunity to contribute to a growing initiative focused on maximizing reimbursement outcomes, improving dispute processes, and reducing claim backlog.

Key Responsibilities:
Manage medical claim disputes and appeals related to the No Surprises Act (NSA) and applicable state surprise billing laws.
Review EOBs, claim history, reimbursement data, and supporting documentation to determine dispute eligibility and strategy.
Prepare detailed written arguments, notices of offer, and supporting documentation for Independent Dispute Resolution (IDR) submissions.
Track and manage multiple claim deadlines to ensure all submissions, responses, and arbitration requirements are completed on time.
Investigate claim payments, denials, underpayments, and reimbursement discrepancies through analysis of payer communications, contracts, and clinical documentation.
Analyze trends and identify opportunities to improve dispute outcomes, workflows, and reimbursement strategies.
Collaborate with revenue cycle, finance, payment management, and practice operations teams to resolve issues and communicate dispute status updates.
Maintain accurate records and trackers throughout the dispute lifecycle while ensuring compliance with federal and state requirements.
Support a growing claims dispute program by contributing process improvements and best practices.

Compensation:
$55,000 to $70,000 per year annual salary.

Exact compensation may vary based on several factors, including skills, experience, and education.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.

3+ years of healthcare claims, appeals, accounts receivable, revenue cycle, or reimbursement experience.
Experience working with the No Surprises Act (NSA), Independent Dispute Resolution (IDR), or similar medical claims dispute processes.
Strong understanding of medical claims processing, EOB review, payer reimbursement methodologies, and healthcare revenue cycle operations.
Excellent written communication skills with the ability to develop persuasive, data-driven dispute arguments.
Strong analytical, organizational, and problem-solving abilities.
Proven ability to manage competing priorities and meet strict deadlines.
Proficiency with Microsoft Excel and Microsoft Office Suite.
Experience working within EMR or healthcare practice management systems.

Experience using Practice Plus.
Experience submitting or managing IDR arbitration cases.
Understanding of ICD-10 and CPT coding.
Bachelor's degree in Healthcare Administration, Business, Finance, or a related field.

Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.