Manager of Provider Compliance

Job Summary

A company is looking for a Manager, Provider Compliance to oversee provider disputes related to the No Surprises Act.

Key Responsibilities

• Oversee compliance with the No Surprises Act and manage QPA claims and IDR determinations
• Conduct advanced claim research and lead provider contract negotiations
• Maintain tracking systems for reporting and drive process enhancements aligned with regulatory requirements

Required Qualifications

• High School Diploma or GED; Bachelor's Degree preferred
• Strong knowledge of the No Surprises Act and provider contracts
• 3+ years of experience in medical billing or claims adjudication
• 1+ year of experience in provider contracting negotiation
• Advanced analytic abilities and proficiency in Microsoft Office Suite