Temporary No Surprises Act (NSA) Operations Specialist

Blue Cross & Blue Shield of Rhode Island•Providence, RI

29d•Hybrid

About The Position

This temporary role provides operational support for No Surprises Act (NSA) processes, including open negotiation and independent dispute resolution activities. The role focuses on case tracking, documentation, and coordination to ensure timely and accurate processing during periods of increased volume.

Requirements

Two to four years of experience in health plan operations
Strong analytical, organizational, operational and communication skills
Ability to manage multiple priorities in a fast-paced, regulatory environment
Ability to organize work efficiently to meet established time and quality standards
Proficient in Excel

Nice To Haves

Bachelor’s degree in Healthcare Administration, Business, Public Health, or related field
Direct experience with the No Surprises Act, IDR, or out-of-network reimbursement
Proficient in Outlook

Responsibilities

Support NSA-related activities for Network Contracting.
Maintain documentation and continuous tracking of cases specific to negotiations and offers for the Open Negotiation Notification and Independent Dispute Resolution (IDR) intake processes.
Review and prepare offers during the open negotiation period.
Prepare dispute documentation (e.g., Qualifying Payment Amount rationale).
Work in collaboration with administrative staff to ensure IDR payments are submitted timely.
Work cross-functionally with GAU and Operations teams.
Identify cases that may not qualify and escalate for review.
Analyze dispute determinations.
Track key metrics (IDR volume, outcomes, turnaround time, financial impact).
Compile data and assist in reporting and analysis.