Job Description
Job Description
Position Summary
The IDR Response Specialist supports the No Surprises Act (NSA) Independent Dispute Resolution process by monitoring and responding to inbound CMS and Certified IDR Entity actions. The role manages multiple response types, compiles supporting documentation, submits required information through the CMS portal, coordinates payment-related actions, and maintains accurate case status updates within AMD. NSA IDR Onshore Staffing needs ...
Key Responsibilities
· Monitor the CMS portal and designated email channels daily for inbound IDR actions and required responses.
· Review Certified IDR Entity selections against the accepted entity list; submit an Entity Reselection Form when required and update AMD.
· Process IDR fee payment requests through Accounts Payable and track invoice number, due date, and payment-cycle status in AMD.
· Review Notice of Offers requests, verify whether a prior offer was submitted, submit the offer through the CMS portal, and upload required QPA supporting documentation.
· Respond to Additional Information Requests by identifying, compiling, and submitting requested documents from AMD, G-Drive, Availity, LIMS, and other approved sources within required deadlines.
· Submit reopen requests to the IDR entity and escalate to a CMS Complaint when appropriate.
· Process IDR Payment Determinations by updating the AMD ARB status with the applicable outcome and recording the QPA awarded amount.
· Complete CMS Complaints through the CMS complaint portal, including compiling supporting documents, capturing the confirmation number, notifying the entity, and updating AMD.
· Triage inbound work by response type, determine the required action, and independently manage each item through completion. NSA IDR Onshore Staffing needs.
Qualifications
· Healthcare billing, claims follow-up, or insurance operations knowledge.
· Ability to triage inbound work by response type and independently determine required next steps.
· Familiarity with EOBs, member benefits, claims documentation, and payor portals.
· Experience with AMD or a similar practice management system preferred.
· Strong written communication skills for CMS portal submissions and correspondence with IDR entities.
· Strong attention to detail, organization, and deadline management.
· Ability to work across multiple systems and retrieve supporting documentation efficiently.
· US-based residency required for CMS portal access. NSA IDR Onshore Staffing needs ...
Key Skills
• CMS Portal • Claims Follow-Up • EOB Review • QPA • AMD • Payor Portals • Document Management • Written Communication • Case Triage • Deadline Management
Experience
Preferred: 1–2 years in healthcare billing, claims follow-up, insurance operations, denial management, or a similar revenue cycle role. Direct experience with IDR, No Surprises Act disputes, or out-of-network claims is preferred.
\nCompany Description
Credence Global Solutions (“CGS”) is a Richardson, Texas based diversified technology driven financial transformation company with deep expertise in receivables management and voice based BPO. With focus on Receivables Management, Healthcare RCM, Technology Platforms and Contact Center verticals, CGS services leading telecommunication, healthcare, and media companies.
Healthcare providers serviced by CGS include medical transport providers, emergency physicians, health infusion service providers and diagnostic laboratories. In the telecommunication vertical, CGS serves four of the top five providers in United States.
Credence Resource Management is the flagship company of the Credence Group.
Our mantra is Excellence Beyond Belief. Challenges, growth opportunities and a passion for the Job enables us to repeatedly deliver excellence to our clients. Our teams are encouraged to continually explore their talents and pursue their interests, giving them the authority to gain knowledge and skills to truly be the expert in their domain. We strive to bring on the best and brightest, as well as to invest in their training and education, making them a seamless extension of your team.
Headquartered in Dallas TX, we have delivery offices in San Jose CA; Natchez MS; Mesa AZ & Pune India. Visit www.credencegs.com to know more about the company.
Company Description
Credence Global Solutions (“CGS”) is a Richardson, Texas based diversified technology driven financial transformation company with deep expertise in receivables management and voice based BPO. With focus on Receivables Management, Healthcare RCM, Technology Platforms and Contact Center verticals, CGS services leading telecommunication, healthcare, and media companies.\n\nHealthcare providers serviced by CGS include medical transport providers, emergency physicians, health infusion service providers and diagnostic laboratories. In the telecommunication vertical, CGS serves four of the top five providers in United States.\n\nCredence Resource Management is the flagship company of the Credence Group.\n\nOur mantra is Excellence Beyond Belief. Challenges, growth opportunities and a passion for the Job enables us to repeatedly deliver excellence to our clients. Our teams are encouraged to continually explore their talents and pursue their interests, giving them the authority to gain knowledge and skills to truly be the expert in their domain. We strive to bring on the best and brightest, as well as to invest in their training and education, making them a seamless extension of your team.\n\nHeadquartered in Dallas TX, we have delivery offices in San Jose CA; Natchez MS; Mesa AZ & Pune India. Visit www.credencegs.com to know more about the company.