Independent Dispute Resolution - Operations Coordinators

Plutus Health Inc. is a leading provider of Revenue Cycle Management (RCM) services, certified in SOC2 compliance and recognized among the Inc. 5000 fastest-growing private companies. We specialize in revenue cycle optimization for hospitals, physician groups, and healthcare organizations across various specialties. Our commitment to innovation and excellence has earned us recognition as a 2024 EY Entrepreneur Of The Year finalist and one of the top 100 fastest-growing companies in Dallas.

Position Overview

Plutus Health is seeking detail-oriented 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 .If you have experience in Medical Billing or Accounts Receivable (AR) but are new to the IDR process, Plutus Health will provide comprehensive training on the IDR portal, payer dispute workflows, and related compliance requirements.

Key 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.
• Good understanding of all the nuances of Out-of-Network Billing "

Required Qualifications

• 1-2 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.

Preferred Qualifications

• 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.

What We Offer

• 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.