Payer Dispute RCM Strategist (Remote)

Own IDR Strategy and Program in Telemedicine Fully Remote

At Access TeleCare were redefining how hospitals and health systems deliver care. As the nations largest provider of telemedicine solutions our platform Telemed IQ brings specialty care to patients wherever they are improving outcomes while optimizing operational efficiency.

We provide healthcare teams with industry-leading solutions that drive improved clinical care patient outcomes and organizational health. We are proud to be the first provider of acute clinical telemedicine services to earn The Joint Commissions Gold Seal of Approval and have maintained that accreditation every year since inception.

The Opportunity

Were seeking a Payer Dispute Revenue Cycle Management (RCM) Strategist to take ownership of a critical initiative for our business: building and leading our Independent Dispute Resolution (IDR) program under the No Surprises Act.

This is a rare opportunity to step into a high-impact and high-visibility role where your work will directly translate to lasting organizational value. Youll be working across many different functions in our business engaging with leadership and shaping a function that is currently very nascent. Youll be managing both in-house and vendor-based components of the arbitration process ensuring compliance with federal and state regulations identifying opportunities to improve processes and facilitating effective claims processing.

The right candidate is analytical and eager to prove themselves by owning these process end-to-end proactively uncovering data insights and driving outcomes with urgency. If youre excited by fast-paced environments energized by collaboration and motivated to make your mark on a growing organization this is the role for you.

What Youll Do

• Build and own the Independent Dispute Resolution program from start to finish from managing disputes and vendors to shaping reporting process and strategy
• Act as the face of this initiative with executive leadership regularly communicating updates and insights
• Dig deep into disputed claims analyzing data to spot trends uncovering opportunities and proactively translating findings into revenue cycle management actions that improve out of network commercial claim processing and denials management
• Coordinate across a variety of interdependent functions that support RCM processes including analytics auditing technology and payer enrollment
• Maintain up-to-date knowledge of payer guidelines state/federal regulations and industry standards to ensure accurate documentation and compliance with all requirements throughout program
• Collaborate and communicate with payers during the arbitration process to reach a mutually beneficial resolution where possible and support continually improving payer relations
• Monitor outcomes track performance and connect the dots between process improvements and financial impact throughout arbitration and resolution processes
• Oversee & support vendors and third parties responsible for coordinating arbitration steps involving day-to-day relationship management and data analysis
• Develop the long-term strategy for our payer dispute process beyond the end-to-end process steps of the IDR program to expand into a more holistic organizational strategy
• Other duties as assigned

What Youll Bring

• Bachelors degree required (Healthcare Administration Business or related field)
• 5 years of experience with deep exposure to Revenue Cycle Management (RCM) or a related healthcare finance role
• 2 years of experience at a top management consulting firm required in a setting where problem-solving cross-functional collaboration and executive communication were critical to success
• Certification such as Certified Revenue Cycle Specialist (CRCS) or Certified Professional Biller (CPB) preferred but not required
• Experience with the Independent Dispute Resolution (IDR) process under the No Surprises Act (NSA) preferred but not required
• Strong analytical skills: advanced Excel working with large datasets and ability to use tools like Tableau
• Excellent written and verbal communication;comfortable presenting to executive leadership collaborating across teams and influencing outcomes
• Negotiation and conflict-resolution skills to advocate for claim approvals
• Strong knowledge of healthcare billing coding and payer requirements
• High attention to detail with excellent organizational skills
• Ability to interpret and apply payer policies state and federal regulations and compliance standards
• Strong time management with the ability to handle high-volume workloads
• Complex project management skills including managing cross-functional initiatives
• Collaborative mindset with ability to work across teams
• Proficient in Microsoft Office Suite or related tools
• Familiarity with HIPAA and healthcare compliance standards
• Ability to thrive in a high-growth fast-paced and remote environment
• Ability to remain in a stationary position 50% of the time
• Ability to travel occasionally

Why Join Access TeleCare

• Strong compensation with performance-based incentives
• 100% Remote with national visibility
• Comprehensive benefits health dental vision life and 401(k)
• Flexible vacation and wellness time
• A culture of ownership transparency and results

Ready to make an impact Apply today and help shape the future of virtual healthcare.

Access TeleCare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age marital status national origin disability protected veteran status race religion sex or any other characteristic protected by applicable laws and regulations. We also consider qualified applicants regardless of criminal histories consistent with legal requirements.