Job Details

Job Title: Senior Admin-Appeals
Location: Remote, VA 23219
Duration: 3-6 months+ (Possible Extension)

Hours of Operations: 9:00 am - 5:00 pm, EST

Required Skills:

• We are seeking a detail-oriented and service-driven Administrative Specialist to support the operations of the New York Independent Dispute Resolution Program.
• This role is essential in ensuring accurate data management, timely communication, and compliance with regulatory standards under the New York Surprise Billing Laws.

• Data Collection & Analysis:
  • Gather and review incoming documentation from treatment providers, healthcare facilities, program participants, laboratories, and health plans.
  • Accurately input relevant data into internal systems to support case processing and program tracking.
• Client Communication:
  • Respond promptly and professionally to inquiries from clients, health plans, providers, and enrollees.
  • Provide updates on case status and clarify program-related questions via email and other communication channels.

• Exceptional Attention to Detail:
  • Precision is critical to ensure the integrity of shared information and maintain compliance with federal and state regulations.
  • Accuracy helps prevent disputes and supports fair determinations.
• Customer Service Orientation:
  • Demonstrated ability to communicate effectively and empathetically with diverse stakeholders in a fast-paced environment.
• Deadline-Driven Mindset:
  • Comfortable working in a production-based setting with time-sensitive tasks and performance metrics.
• Technical Knowledge:
  • Familiarity with CPT (Current Procedural Terminology) codes.
  • Strong ability to interpret claim forms and Explanation of Benefits (EOBs).
  • Understanding of the No Surprises Act and its impact on billing and dispute resolution processes.

• Prior experience in healthcare administration, insurance claims processing, or regulatory compliance.
• Proficiency in data entry systems and Salesforce (preferred).