Maryland Licensed Jurisdictional Advisor

Job Summary

A company is looking for a Jurisdictional Advisor.

Key Responsibilities

• Lead the Jurisdictional Review Process for eligibility determinations in the Federal Independent Dispute Resolution program
• Collaborate with IDR leadership and engineering teams to enhance tools and workflows for dispute resolution
• Maintain regulatory compliance with the No Surprises Act and optimize workflow processes for efficiency and accuracy

Required Qualifications, Training, and Education

• Bachelor's degree in a health-related field, with experience or coursework in healthcare and/or biological sciences
• Medical coding certification is preferred
• Proven experience in healthcare eligibility, medical necessity, or revenue integrity management
• Knowledge of the No Surprises Act and CMS regulations
• Experience leading regulatory staff teams and optimizing operational workflows