NSA & IDR Reimbursement Specialist

Job Summary

Managing the No Surprises Act (NSA) reimbursement process for out-of-network air ambulance claims, the full-time NSA & IDR Reimbursement Specialist will review payer determinations, identify claims for Open Negotiation and Independent Dispute Resolution (IDR), and ensure compliance while maximizing reimbursement in a remote environment.

Key responsibilities

• Review out-of-network air ambulance claims for NSA eligibility and analyze payer reimbursement determinations
• Initiate and manage Open Negotiation requests and prepare IDR cases for submission through the federal IDR portal
• Communicate with insurance carriers and stakeholders regarding payment disputes and monitor compliance with awarded reimbursement amounts

Required qualifications

• High School Diploma or equivalent required; Associate degree preferred
• Minimum of 2 years of experience in healthcare claims processing, billing, or reimbursement recovery
• Hands-on experience with insurance appeals and understanding of payer denial codes
• Familiarity with ICD-10, HCPCS, and medical terminology
• Proficiency in Microsoft Word, Excel, and Outlook