Job Details

A company is looking for a Manager, Provider Compliance to oversee provider disputes related to the No Surprises Act.Key ResponsibilitiesOversee compliance with the No Surprises Act and manage QPA claims and IDR determinationsConduct advanced claim research and lead provider contract negotiationsMaintain tracking systems for reporting and drive process enhancements aligned with regulatory requirementsRequired QualificationsHigh School Diploma or GED; Bachelor's Degree preferredStrong knowledge of the No Surprises Act and provider contracts3+ years of experience in medical billing or claims adjudication1+ year of experience in provider contracting negotiationAdvanced analytic abilities and proficiency in Microsoft Office Suite