Top 35 Idr process Jobs in Remote

Regulatory Process Manager (IDRE)
PROVIDER RESOURCES INC —Remote
- $125,000 - $175,000 a year
- Full-time
- Remote
- Continuous improvement
- Training & development
- Senior level
Quick Apply
IDR Analyst
Anesthesia Dynamics —Dallas, TX
- Full-time
- Remote
- Writing skills
- HIPAA
- Research
- Health insurance
- Paid time off
Compliance Support Specialist
TRES HEALTH INC —Remote
- Remote
- Research
- Mid-level
- Office
Manager of Compliance Audit
PROVIDER RESOURCES INC —Remote
- $105,000 - $155,000 a year
- Full-time
- Remote
- 5 years
- Senior level
- Analytics
Quick Apply
Medical Billing AR Specialist – Appeals & Out-of-Network Expert
Adelfi Medical Billing Solutions —Remote
- $65,000 - $70,000 a year
- Full-time
- Remote
- 5 years
- Writing skills
- Senior level
- Health insurance
Provider Reimbursement Specialist - Fee Schedules
Fidelis Care —Rego Park, NY
- $56,200 - $101,000 a year
- Full-time
- Remote
- Research
- Mid-level
- Analysis skills
- Paid holidays
- Health insurance
Student Loan Specialist
Auguste Escoffier School of Culinary Arts —Remote
- Full-time
- Remote
- Microsoft Outlook
- Computer literacy
- High school diploma or GED
- Paid holidays
- Disability insurance
Quick Apply
Director of Compliance
PROVIDER RESOURCES INC —Remote
- $165,000 - $190,000 a year
- Full-time
- Remote
- Senior level
- Leadership
- 10 years
Quick Apply
Director of Stakeholder Engagement
PROVIDER RESOURCES INC —Remote
- $165,000 - $215,000 a year
- Full-time
- Remote
- Analysis skills
- Senior level
- Communication skills
- Health savings account
- Health insurance
Quick Apply
Data Analytics Consultant - Health
Blu Omega —Washington, DC
- $90,000 - $139,000 a year
- Remote
- Master's degree
- US work authorization
- Senior level
- AD&D insurance
- Paid holidays
Stakeholder Engagement Manager (IDRE)
PROVIDER RESOURCES INC —Remote
- $125,000 - $175,000 a year
- Full-time
- Remote
- Senior level
- Commercial
Quick Apply
Medical Dispute Specialist (WorkComp)
WELLRITHMS INC. —Remote
- $65,000 - $75,000 a year
- Full-time
- Microsoft Outlook
- Research
- High school diploma or GED
Quick Apply
5d
Director of Revenue Optimization and Operations
Alliance Health Systems —Remote
- $130,000 - $160,000 a year
- Full-time
- Remote
- Background check
- 5 years
- Mentoring
- Paid holidays
- Health insurance
Quick Apply
Requirements Management Lead / BA- Federal Health
rockITdata —Remote
- Full-time
- Computer Science
- 5 years
- Bachelor's degree
10d
Payor Dispute Coordinator
TeamHealth —Knoxville, TN
- Full-time
- Remote
- Data analysis skills
- Research
- Mid-level
8d
Evaluation & Assessment Analyst- Federal Health
rockITdata —Remote
- Full-time
- 5 years
- SQL
- Analysis skills
10d
Test Engineer- Federal Health
rockITdata —Remote
- Full-time
- Computer Science
- Mid-level
- 3 years
10d
Senior Systems Programmer, Healthcare Innovations
American Institutes for Research —Chicago, IL
- $135,000 - $165,000 a year
- Email
- Remote
- Master's degree
- 8 years
- Analysis skills
Director, Product - XDR
Arctic Wolf —Remote
- $186,000 - $302,000 a year
- Full-time
- Remote
- Continuous improvement
- Product management
- Senior level
- Paid parental leave
- AD&D insurance
11d
Configuration / Data Management Analyst- Federal Health
rockITdata —Remote
- Full-time
- Computer Science
- Mid-level
- 3 years
10d

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Regulatory Process Manager (IDRE)

PROVIDER RESOURCES INC -
Remote

Quick Apply

Job Details

Full-time
$125,000 - $175,000 a year

Qualifications

Optimizing workflow processes
Healthcare dispute resolution
Commercial dispute resolution
Investigations regulatory compliance
Defect resolution root cause analysis
Process audits
Law
Utilization review
Case assessment
Webinars
Managed care
Managed care organization experience
Master's degree in law
CMS
Incident Escalation
Doctor of Law (JD)
Pattern recognition
CMS regulatory compliance
Case review audits
Continuous improvement
Decision making
Content development
Quality improvement
Insurance claims arbitration
Document review
Regulatory readiness in healthcare
Investigating compliance violations
Training & development
Root cause analysis
Senior level

Full Job Description

About PRI LLC:

Provider Resources Inc. (PRI LLC) is a federally certified Independent Dispute Resolution Entity (IDRE) and Independent Review Organization (IRO) operating under the No Surprises Act. We process payment disputes that directly protect patients from unexpected medical bills — and we do it at scale, with precision, in one of the most scrutinized regulatory environments in healthcare. We are a growth-stage company of approximately 200 people, backed by a search fund, and building the systems and team that will define PRI LLC for the next decade.

The Role:

We are looking for a Regulatory Process Manager — PRI LLC's subject matter expert and go-to investigator for complex issues within the No Surprises Act IDR process. This is a senior individual contributor role that sits at the intersection of regulatory expertise, case investigation, and process improvement.

You will be the person PRI LLC calls on when a dispute is complex, a CMS guidance question is novel, or an exception pattern needs someone to dig in and figure out what is happening. You will investigate, document, recommend, and communicate — and you will do it independently, at speed, without needing a committee to validate your work.

What You Will Do:

Interpret NSA rules, CMS guidance, and PRI LLC procedures in real time without escalating routine questions upward
Investigate complex exceptions in our case files — identify root causes, report patterns, recommend process improvements
Conduct auditlevel case file reviews in GlideOps to answer stakeholder questions with specificity and documentation
Track CMS guidance and interim final rules; communicate relevant changes to internal stakeholders proactively
Manage escalated disputes through to resolution, coordinating with QA, compliance, and operations
Support the CCO and VP Compliance on CMS and URAC audits and regulatory correspondence
Collaborate with L&D and Compliance on developing training content for complex IDR process areas
Represent PRI LLC at external meetings, webinars, and educational events as a subject matter authority

What We Are Looking For:

JD or LLM preferred; significant NSA/IDRE operational, regulatory, or arbitration experience considered in lieu
Arbitration experience — IDR arbitration ideal; AAA, JAMS, AHLA, or commercial arbitration background considered
Deep familiarity with the No Surprises Act IDR process — you know it well enough to catch errors and explain edge cases
Auditor instinct: when something is complex, you move toward it, not away from it
Experience identifying patterns across large case volumes and translating them into process improvements
Ability to make decisions independently and move fast without committee input on regulatory questions
Prior IDRE, IRO, managed care, utilization review, or healthcare regulatory environment experience

Why PRI LLC:

Meaningful work — PRI LLC processes disputes that directly protect patients from unexpected medical bills under federal law
Growth stage — we are building the systems, processes, and team that will define PRI LLC for the next decade
Skills framework — every role at PRI LLC has a defined skills ontology with clear growth paths and Udemy Business development pathways
Highvisibility role — your work shapes how PRI LLC operates at the regulatory edge; findings you surface reach executive leadership
Direct leadership access — small enough that your work is visible; structured enough that decisions get made

PRI LLC is an equal opportunity employer. We evaluate candidates on demonstrated skills and capability.

About PROVIDER RESOURCES INC

Join Provider Resources (PRI) and Make an Impact in Healthcare! At PRI, we’re passionate about driving integrity and advancing quality across the healthcare system. As a trusted leader in the industry, we’re tackling some of healthcare’s biggest challenges—improving compliance, advancing health equity, and enhancing quality and clinical outcomes while helping organizations improve care delivery and create meaningful change. We believe that people are at the heart of healthcare, and focus on scalable, person-centered strategies that prioritize clinical excellence and evidence-based practices. Our work supports a broad network of stakeholders, including providers, patients, caregivers, payers, and regulators. We strive to enhance experiences, improve outcomes, and foster a healthier future for all. If you’re looking to be part of a forward-thinking team that makes a difference, PRI is the place for you!

Quick Apply

Refine Your Search

idr process jobs in remote

Regulatory Process Manager (IDRE)

IDR Analyst

Compliance Support Specialist

Manager of Compliance Audit

Medical Billing AR Specialist – Appeals & Out-of-Network Expert

Provider Reimbursement Specialist - Fee Schedules

Student Loan Specialist

Director of Compliance

Director of Stakeholder Engagement

Data Analytics Consultant - Health

Stakeholder Engagement Manager (IDRE)

Medical Dispute Specialist (WorkComp)

Director of Revenue Optimization and Operations

Requirements Management Lead / BA- Federal Health

Payor Dispute Coordinator

Evaluation & Assessment Analyst- Federal Health

Test Engineer- Federal Health

Senior Systems Programmer, Healthcare Innovations

Director, Product - XDR

Configuration / Data Management Analyst- Federal Health

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About PRI LLC:

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