Technical (Case) Analyst

Technical (Case) Analyst, Remote

• Contract to Hire
• Remote
• U.S. citizen or authorized to work in the U.S., with at least three years of verifiable U.S. residency in the last five years
• Ability to obtain and maintain a Public Trust Government Clearance
• NO THIRD PARTY RECRUITERS.

We are seeking a Technical (Case) Analyst to join our client's team.

The federal Independent Dispute Resolution (IDR) process plays a critical role in resolving eligible out-of-network payment discrepancies between providers, facilities and health plans under the No Surprises Act. As part of a multidisciplinary team, the Technical (Case) Analyst will support this mission by conducting detailed reviews of medical and billing documentation, evaluating information from involved parties and contributing to efficient, accurate and compliant case outcomes.

Responsibilities

• Access and review disputes in the Federal IDR Portal.
• Conduct case file reviews across multiple government and IDRE systems and databases, applying prior medical record and/or case management experience.
• Assess cases and develop findings to support eligibility determinations and other dispute-related decisions, while consistently meeting productivity, quality and timeliness standards for triaging and resolving open disputes.
• Identify gaps in documentation and materials by reviewing case files for incomplete, unclear, or missing information and initiate appropriate follow-up actions.
• Recommend improvements to business processes, workflows and case intake and management practices through contribution and development of guidance materials, including training resources, job aids and operational documentation.
• Collect and synthesize data from multiple sources, including web-based systems, client databases and other authorized systems

Minimum Qualifications

• U.S. citizen or authorized to work in the U.S., with at least three years of verifiable U.S. residency in the last five years.
• Ability to obtain and maintain a Public Trust Government Clearance
• High school diploma, or equivalent. Bachelor’s degree in healthcare administration, public policy, public health or related field preferred.
• 2 or more years of relevant experience in medical record case management, benefits or eligibility processing, health program operations, or similar high-volume, process-driven environments.
• Experience with case management systems, CRM platforms, or similar data tools
• Detail-oriented with the ability to manage moderate to high case volumes, follow structured workflows and apply sound judgment.
• Effective written and verbal communication skills, with the ability to convey information clearly and professionally across stakeholders.
• Willingness to report to the Woodlawn, MD headquarters, or other designated location, to engage in project-related activities. Required attendance may occur at regular intervals and span multiple days (typically two).

Preferred

• Experience supporting federal or state health programs (e.g., CMS, Medicaid, Medicare)
• Familiarity with HIPAA and federal data handling requirements
• Experience working in regulated, audit-driven environments