IDR Portal Access Specialist

Calpion/Plutus Health • Addison, TX

6d

About The Position

Plutus Health Inc. is a leading provider of Revenue Cycle Management (RCM) services with SOC2 Certification. We are dedicated to helping healthcare providers improve their financial performance. Our expertise spans across various specialties. We are committed to delivering exceptional service and innovative solutions to our clients. As a result, Plutus Health Inc. has been recognized on the 5000 list of the fastest-growing private companies in America and ranked 100 in the Dallas area. Additionally, the company has been a 2024 finalist in the EY Entrepreneur Of The Year.

As part of our continued operational expansion and evolving payer compliance requirements, we are looking to hire dedicated professionals to support access and operational management of the new IDR (Independent Dispute Resolution) portal in alignment with updated payer and regulatory guidelines.

Plutus Health is seeking detail-oriented and process-driven professionals to manage and support activities related to the new IDR portal and payer dispute workflows. The ideal candidate will be responsible for accessing, reviewing, tracking, and coordinating IDR-related cases while ensuring compliance with updated portal usage guidelines and payer requirements.

This role requires strong healthcare revenue cycle knowledge, excellent attention to detail, and the ability to work collaboratively with internal AR, denial management, legal/compliance, and operational teams.

Requirements

• 2–5 years of experience in Healthcare Revenue Cycle Management (RCM), AR follow-up, denial management, or claims operations.
• Strong understanding of medical billing, payer workflows, and healthcare reimbursement processes.
• Experience working with payer portals, claim dispute workflows, or IDR processes preferred.
• Familiarity with commercial insurance payers, appeals, denials, and escalation management.
• Strong analytical, organizational, and documentation skills.
• Proficiency in Excel, reporting trackers, and operational dashboards.
• Excellent verbal and written communication skills.
• Ability to work independently in a fast-paced operational environment.

Nice To Haves

• Experience handling IDR, arbitration, appeals, or out-of-network reimbursement workflows.
• Exposure to healthcare compliance, audits, and payer regulations.
• Experience working with offshore operational teams.
• Knowledge of CMS guidelines and payer dispute resolution processes.

Responsibilities

• Access and manage the new IDR portal in compliance with updated regulatory and payer usage guidelines.
• Review, monitor, and track IDR cases, disputes, and documentation requirements.
• Coordinate with AR follow-up, denial management, billing, and compliance teams regarding disputed claims.
• Ensure timely submission of supporting documentation and payer communications.
• Maintain accurate logs, reports, trackers, and case status updates.
• Analyze claim disputes, reimbursement discrepancies, and payer responses.
• Escalate high-priority or compliance-related issues to leadership teams.
• Work closely with offshore and onshore operational teams for workflow coordination.
• Support process improvement initiatives for IDR and denial management operations.
• Ensure HIPAA compliance and adherence to organizational SOPs and payer regulations.
• Assist leadership with operational reporting, metrics, and audit readiness activities.

Benefits

• Opportunity to work with a rapidly growing healthcare RCM organization.
• Exposure to evolving healthcare operational and compliance workflows.
• Collaborative and growth-focused work culture.
• Career advancement opportunities within AR, denial management, and operational leadership teams.

What This Job Offers

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