IDR Analyst

recoursehealth.com • San Francisco, CA

6d

About The Position

Run the federal arbitration cases that recover real money for real providers. Make the system smarter with every one. A federal arbitration system called Independent Dispute Resolution, or IDR, now determines billions of dollars in healthcare payments each year. Providers win the vast majority of disputes, yet most eligible claims are never filed. The process is manual, fragmented, and resource-intensive, and most providers don't have the infrastructure to pursue what they're owed. The No Surprises Act created the framework, and the market already exists. Today it runs on spreadsheets, consultants, and static playbooks. We're building the first intelligent system designed to operate inside it. This role sits inside that system. You will run real disputes end to end: eligibility, deadlines, submissions, correspondence, resolution. Every claim you touch teaches us something about how to make the next one better. You will not inherit a mature process. You will help build it. Claims data is messy. Payers adapt. Deadlines cascade. Audit trails matter. One missed detail can cost a provider real money, or cost us a CMS fee on a dispute we never should have filed. You'll develop sharp instincts for where money gets left on the table and where the system needs a better guardrail. The second half of the job is improving the process. When you spot a pattern in the claims, you write it down, we build it, and the next hundred disputes run better because of you. The job grows as you do. In month one you're running cases. By month six you're deciding how they should be run, steering the tooling that handles the routine parts, and spending your time on the disputes that actually need judgment. This role is for someone directing AI rather than being impacted by it.

Requirements

• 2 to 4 years in revenue cycle, claims operations, denials, appeals, or medical billing
• Comfortable reading EOBs, 835 remittance files, CPT codes, and claim adjustment reason codes
• Hands-on fluency with AI tooling (Claude, ChatGPT, or similar). You have used it to ship or accelerate real work, not just tried the demos
• Comfort with data and analytical tools (Excel or Sheets at pivot-table level, SQL a plus). You can pull answers yourself rather than filing a request
• Clear written communication. You can turn a messy situation into a crisp summary
• The ability to manage a lot of competing deadlines without dropping any of them
• A preference for small teams and early-stage chaos over mature org charts
• Sound judgment, operational depth, and ownership mindset are required.

Nice To Haves

• Direct experience with Independent Dispute Resolution, the No Surprises Act, arbitration, or out-of-network claims.

Responsibilities

• Evaluate dispute eligibility against federal IDR requirements before anything gets filed
• Own submissions through the CMS portal: documentation, offer amounts, supporting briefs
• Monitor deadlines across active disputes and make sure nothing lapses on procedure
• Handle correspondence with payers and IDR entities, and track every follow-up to close
• Verify cases actually resolved, catching premature or missed closures before they cost us money
• Read 835 remittance files and EOBs to reconstruct what a payer actually did and why
• Turn every recurring pattern you spot into a spec, a checklist, or a prompt that makes the next case easier
• Work directly with AI tools to take the repetitive parts off your plate, then partner with engineering to make those improvements permanent

Benefits

• Institutional backing
• Shared platform team spanning engineering, strategy, design, and back-office
• Early access to large provider systems
• Funded, validated opportunity with real customers and real data
• Small, nimble team
• Clarity over theater
• Opportunity to do the best work of your career
• Supportive culture where people do their best work

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed