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.

Requirements

• You have real claims instincts. You can read an EOB and tell what happened. You know what a denial code means without looking it up. You've chased a payer for money that was owed and you know how that conversation goes.
• You are AI-pilled. You've used AI tools to do work that would have taken a team. You have opinions about which ones are useful and which are hype. You stay current because the world is changing and you want to see the next shift before anyone else.
• You care about the details. You notice when a number is slightly off. You follow the thread until you understand it. In this work, one missed detail is real money.
• You have a bias to action. You don't default to no. Speed of iteration over polish of iteration. You start, you learn, you fix things in motion. Most decisions are reversible and do not need extensive study.
• You are intellectually honest and curious. You ask questions when you don't understand something. You say so when you're wrong. You use plain language. You respectfully challenge decisions you disagree with, and once a decision is made, you commit.
• You put the team first. You are reliable and fully invested. You take your vacations. You check on your teammates. You help build a culture where people do their best work because they are supported, not squeezed.
• 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. Grit matters more than pedigree.

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

What This Job Offers

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