Dispute Selection Specialist

About the role

Imagine360 is seeking a Dispute Selection Specialist to join the team! The Dispute Selection Specialist role will involve essential handling of No Surprises Act claims. This will include researching claims for eligibility and reviewing and analyzing trends and data to strategically respond to Independent Dispute Resolution (IDR) notices in the CMS Portal. Position Location: 100% remote

Responsibilities

• Respond to Independent Dispute Resolution (IDR) requests in the IDR portal.
• Research claims to confirm eligibility for handling according to the No Surprises Act (NSA).
• Close cases based on the IDR determinations.
• Assist management with various tasks and assignments.
• Triage inquiries and questions from internal and external partners.
• Report any system issues.
• Meet daily production goals and performance objectives.
• Adhere to HIPAA guidelines and regulations.
• Other projects and duties as assigned.

Requirements

• Bachelor's degree preferred
• Minimum 1 year of healthcare, health insurance, or customer service experience

Skills

• Excellent communication (written, verbal, and listening), interpersonal, and analytic skills
• Experience with negotiations preferred
• Knowledge and understanding of CMS1500 and UB04 Medical Claim Forms, medical coding, and proficiency in Microsoft Office products desired
• Experience in billing, insurance, healthcare, or legal environments is a plus!

Benefits

• Multiple Health plan options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Company paid Short & Long term Disability plus Life Insurance
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives

About Imagine360

Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.