Temporary No Surprises Act (NSA) Operations Specialist
HybridProvidence, Rhode Island, United States
Job Summary
Support NSA-related activities for Network Contracting by maintaining documentation and continuous tracking of cases specific to negotiations and offers for the Open Negotiation Notification and Independent Dispute Resolution (IDR) intake processes. Review and prepare offers during the open negotiation period, while preparing dispute documentation such as Qualifying Payment Amount rationale and collaborating with administrative staff to ensure IDR payments are submitted timely. Work cross-functionally with GAU and Operations teams to identify cases that may not qualify and escalate for review, while analyzing dispute determinations and tracking key metrics including IDR volume, outcomes, turnaround time, and financial impact. Compile data and assist in reporting and analysis to ensure timely and accurate processing during periods of increased volume.
Required Qualifications
- Two to four years of experience in health plan operations", "Strong analytical, organizational, operational and communication skills", "Ability to manage multiple priorities in a fast-paced, regulatory environment", "Ability to organize work efficiently to meet established time and quality standards", "Proficient in Excel", "Direct experience with the No Surprises Act, IDR, or out-of-network reimbursement
Desired Qualifications
- Bachelor's degree in Healthcare Administration, Business, Public Health, or related field
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