IDR Analyst (Federal and State)
$55,000–$65,000 year
RemoteUnited States
Job Summary
Evaluate dispute eligibility and documentation by analyzing claim information to ensure cases meet federal IDR or state-specific requirements before submission. Research and interpret state regulatory requirements, translating laws and agency guidance into clear instructions for the team. Own inbox and correspondence review by monitoring shared inboxes, responding to payors and IDR entities, and tracking follow-ups. Ensure accurate case closures by confirming disputes are resolved and catching premature or missed closures. Monitor arbitration timelines and correspondence to track deadlines and review communications from health plans and internal teams. Maintain operational tracking and documentation by updating internal systems and spreadsheets to keep case records and metrics accurate. Support operational improvements by refining workflows and flagging system issues to analytics and product teams.
Required Qualifications
- 2–4 years of experience in revenue cycle operations, claims management, or reimbursement/insurance operations
- Experience with medical billing or coding; comfortable reading EOBs, claims, and reimbursement codes
- Comfortable working in Excel or Google Sheets, including building and using pivot tables, to track cases and data
- Strong attention to detail and analytical thinking; ability to review documentation, catch inconsistencies, and determine next steps
- Ability to manage a high volume of competing deadlines with strong written communication
- Comfortable exercising judgment and asking thoughtful questions rather than waiting for every next step to be prescribed; able to make well-supported recommendations and grow into more independent ownership of your day to day
- Candidates must be authorized to work in the United States without current or future employer sponsorship
Desired Qualifications
- Familiarity with Independent Dispute Resolution (IDR), arbitration, or healthcare regulatory workflows
- Experience working with operational tools such as Asana, Metabase, or similar systems
- Medical billing/coding certification (e.g., CPC) or other formal coding training
- Knowledge of state-level IDR regulations in addition to federal requirements
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