Independent Dispute Resolution (IDR) Attorney, NSA Specialist
Job Description
Job Description
Job Summary:
We are a leading out-of-network medical revenue cycle management company specializing in providing comprehensive support to providers. Our services include pre billing, claims processing, arbitration support, and navigating complex regulatory frameworks, such as the No Surprises Act.
We are seeking an experienced Independent Dispute Resolution (IDR) Attorney to oversee and manage our arbitration processes, ensure compliance with federal and state regulations, and contribute to our claims processing operations
**Looking for Lawyer/Attorneys ready to join on immediately**
**Lawyers/Attorneys from this location can apply." New York, New Jersey & Connecticut"**
The ideal candidate will bridge legal and billing expertise to enhance our service offerings.
NOTE- **This position offers a hybrid work arrangement, with 3 days per week in our New York office and 2 days working remotely, blending in-person teamwork with flexible scheduling.**
Key Responsibilities:
- Independent Dispute Resolution Management
- Lead and oversee all IDR activities under the No Surprises Act for out-of-network claims.
- Utilize proprietary arbitration software to track, manage, and resolve disputes efficiently for clients.
- Keep track of all claims in the 90-day cooling off period, and monitor when they can be submitted on the IDR portal
- Follow up on unprocessed disputes or unpaid claims after determination has been made
- Assist with overseeing IDR Representative
- Additional duties and responsibilities as assigned
- Develop and maintain relationships with arbitrators, legal professionals, and other stakeholders.
- Monitor regulatory updates and ensure compliance with arbitration-related laws and guidelines.
- Support and streamline claims processing operations to ensure accurate and timely handling of out-of-network claims.
- Collaborate with the claims team to identify potential arbitration cases and strategize resolutions.
- Serve as a key point of contact for clients regarding arbitration cases and claims processing.
- Provide expert guidance on dispute resolution processes to clients and internal teams.
- Analyze and improve workflows for arbitration and claims processing.
- Represent Sunknowledge and clients in Federal IDR proceedings, preparing and submitting offers to resolve payment disputes with health plans.
- Review and draft legal documents, including contracts, IDR submissions, and compliance policies for billing operations.
- Collaborate with our billing team to ensure claims align with NSA requirements and maximize collections.
- Mitigate legal risks by ensuring all billing practices comply with federal and state healthcare laws and more.
Education:
- Juris Doctor (JD) or Paralegal Certification highly preferred.
- Equivalent experience in healthcare arbitration, revenue cycle management, or legal support will be considered.
Experience
- Minimum 2+ years of direct experience with out-of-network medical claims, arbitration, or dispute resolution.
- In-depth knowledge of the No Surprises Act and related regulations.
- Familiarity with arbitration platforms and claims processing systems.
- Experience with IDR arbitration or dispute resolution preferred
Skills
- Exceptional organizational and analytical abilities.
- Strong understanding of medical billing and coding as it relates to out-of-network claims.
- *Candidates must have demonstrated experience in handling IDR (Independent Dispute Resolution), NSA (No Surprises Act), and out-of-network claim cases on behalf of healthcare providers.
- Strong understanding of State and federal laws
- Excellent communication and negotiation skills.
Company DescriptionWe are Sunknowledge Services Inc., an ISO 27001:2022 certified, American-owned & operated company headquartered in New York City, and a leading global provider of Business and Knowledge Process Outsourcing services in the US healthcare domain.
Company Description
We are Sunknowledge Services Inc., an ISO 27001:2022 certified, American-owned & operated company headquartered in New York City, and a leading global provider of Business and Knowledge Process Outsourcing services in the US healthcare domain.