The IDR Lead Analyst acts as a senior subject matter expert, providing analytical oversight, quality assurance, and mentorship to ensure compliance and accuracy in IDR dispute submissions under the No Surprises Act and state programs. Partnering with the IDR Manager, this role identifies process gaps, optimizes workflows, and drives data-informed improvements across client portfolios.
The Opportunity:- Oversee end-to-end IDR workflow for assigned clients, ensuring accuracy, timeliness, and compliance in all submissions.
- Serve as escalation point for complex eligibility reviews, payer communications, and arbitration documentation.
- Audit and validate analyst submissions for accuracy and adherence to federal/state IDR requirements.
- Monitor and report on operational KPIs (acceptance rate, win/loss outcomes, turnaround time).
- Manage advanced reconciliation tasks across payments, adjustments, and returned accounts.
- Collaborate with Analytics and Product teams to enhance reporting, workflow automation, and data validation.
- Identify trends in payer behavior, eligibility, and outcomes to inform team strategy and improve win rates.
- Mentor and coach IDR Analysts on complex cases, technical accuracy, and prioritization.
- Act as a bridge between analysts and management for operational questions, best practices, and feedback.
What you bring:- Bachelor's degree in Healthcare Administration, Business, or related field (or equivalent experience).
- 5+ years of experience in healthcare revenue cycle management or payer disputes, with at least 2+ years in IDR or OON operations.
- Deep understanding of No Surprises Act requirements, payer submission protocols, and arbitration processes.
- Advanced proficiency in Excel and healthcare data systems (Epic, Athena, etc.).
- Strong analytical, organizational, and communication skills with proven ability to manage multiple priorities.
The above statements are intended to provide the general nature and level of work being performed by most people assigned to the position. They are not intended to be an exhaustive list of all responsibilities, duties and requirements.
This position is remote and requires a dedicated, distraction-free work space at home. We offer a competitive benefits package including medical, dental, vision, life insurance, short term disability, long term disability, paid holidays, 401k, and a generous PTO policy.
Knowtion Health gives priority to applicants located in the following states: AL, AR, AZ, FL, GA, ID, IN, KS, ME, MI, MO, MS, NC, NM, OK, PA, SC, TN, TX, VA, WI, WV
