Sr. Associate/Associate - Medical Coder (No Surprises Act Expertise Mandatory)

We are currently hiring an experienced Medical Coder with specialized knowledge of out-of-network claims, the No Surprises Act (NSA) and Independent Dispute Resolution (IDR) process.

Key Responsibilities

• Perform end-to-end medical billing and coding using ICD-10, CPT, and HCPCS codes.
• Ensure accurate claim submissions in compliance with insurance policies and federal regulations.
• Apply knowledge of the No Surprises Act in handling, negotiating and maximizing out-of-network claims.
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  Coordinate and manage Independent Dispute Resolution (IDR) processes, including case filing, documentation, and follow-ups.
• Work closely with relevant stakeholders to resolve claim rejections and denials related to NSA disputes.
• Maintain documentation and audit trails for NSA/IDR-related cases.
• Keep up-to-date with evolving CMS guidelines and payer policies.
• Collaborate with internal teams to improve billing workflows and compliance practices.

Required Qualifications

• Minimum 3+ years of experience in medical billing and coding with minimum 1 year of experience of NSA (No Surprises Act) and IDR related processes.
• Strong knowledge of insurance billing guidelines, HIPAA, CMS guidelines.
• Familiarity with EMR/EHR systems and billing software (e.g., Kareo, AdvancedMD, eClinicalWorks, etc.).
• Excellent analytical, communication, and documentation skills.