Payor Dispute Coordinator

852386, No, 5770, 2337, 1, 0.0, 0.0, 20-Jul-2026, Payor Dispute Coordinator, Full-Time, Payor Dispute Coordinator, Remote, Knoxville, TN, Preferred Qualifications:

• Minimum of 1-2 years of experience (or demonstrated exposure) in one or more of the following:

• Healthcare revenue cycle

• Provider or Facility Payor disputes or arbitration support

• Managed care or out-of-network billing

• Direct experience with:

• Federal Independent Dispute Resolution (IDR) processes

• No Surprises Act compliance

• Working knowledge of:

• Diagnosis-Related Group (DRG) reimbursement

• Medicare reimbursement structures

Skills & Competencies:

• Detail-oriented with strong deadline and caseload management abilities
• Analytical mindset with experience in payment comparison and variance analysis
• Clear written communication skills for arbitration narratives and supporting documentation
• Ability to manage high volumes of disputes while maintaining compliance and accuracy
• JOB DESCRIPTION OVERVIEW:

This role offers a unique opportunity to contribute to the ongoing development and success of our Independent Dispute Resolution (IDR) operations under the No Surprises Act, a federal law that protects patients from surprise medical billing.

As a Payor Dispute Coordinator, you will play a key role in preparing and supporting arbitration filings related to payment disputes between providers and health plans. You will collaborate with internal teams and external vendors to ensure accurate, timely, and strategic handling of dispute workflows.

This is an ideal position for individuals looking to enter or grow within the revenue cycle space, particularly in an evolving, high-impact area of regulatory operations in today's healthcare world.

Essential Duties and Responsibilities:

IDR Case & Dispute Management

• Prepare, initiate, and manage payment disputes through the Federal Independent Dispute Resolution (IDR) process
• Support both physician and facility-based OON claims
• Track all regulatory deadlines, including open negotiation periods, IDR filing windows, arbitrator decisions, and payment timelines
• Maintain detailed, accurate logs and documentation of dispute activity, offers, determinations, and outcomes

Claims Review & Analysis

• Review claims to determine IDR eligibility
• Analyze payment variances using billed charges, payer reimbursement, QPA, Medicare benchmarks
• Compile, validate, and organize supporting documentation for arbitration submissions
• Ensure claim and submission accuracy to support successful arbitration outcomes and maximize provider reimbursement

Data, Vendor, & Stakeholder Coordination

• Enter and maintain accurate dispute data within internal systems, federal portals, and tracking tools
• Serve as a liaison between internal teams (billing, contracting, compliance) and external vendors (arbitration entities, consultants)
• Track, reconcile, and follow up on vendor invoices related to arbitration and dispute services

Compliance & Process Support

• Ensure disputes are filed in a timely, compliant, and organized manner in alignment with the No Surprises Act
• Utilize health plan provider portals and claims systems to support dispute research and follow-up
• Collaborate cross-functionally to support process improvements, audits, and special projects
• Continuously learn and apply evolving regulations related to IDR, revenue cycle workflows, and reimbursement standards