Maryland Licensed Jurisdictional Advisor
A company is looking for a Jurisdictional Advisor. Key Responsibilities Lead the Jurisdictional Review Process for eligibility determinations in the Federal Independent Dispute Resolution program Collaborate with IDR leadership and engineering teams to enhance tools and workflows for dispute resolution Maintain regulatory compliance with the No Surprises Act and optimize workflow processes for efficiency and accuracy Required Qualifications, Training, and Education Bachelor's degree in a health-related field, with experience or coursework in healthcare and/or biological sciences Medical coding certification is preferred Proven experience in healthcare eligibility, medical necessity, or revenue integrity management Knowledge of the No Surprises Act and CMS regulations Experience leading regulatory staff teams and optimizing operational workflows
A company is looking for a Jurisdictional Advisor.
Key Responsibilities
Lead the Jurisdictional Review Process for eligibility determinations in the Federal Independent Dispute Resolution program
Collaborate with IDR leadership and engineering teams to enhance tools and workflows for dispute resolution
Maintain regulatory compliance with the No Surprises Act and optimize workflow processes for efficiency and accuracy
Required Qualifications, Training, and Education
Bachelor's degree in a health-related field, with experience or coursework in healthcare and/or biological sciences
Medical coding certification is preferred
Proven experience in healthcare eligibility, medical necessity, or revenue integrity management
Knowledge of the No Surprises Act and CMS regulations
Experience leading regulatory staff teams and optimizing operational workflows
