IDR Analyst

Summary

Recourse AI is a company focused on improving the federal arbitration system for healthcare payments. The IDR Analyst role involves managing and improving the dispute resolution process, ensuring eligibility, submissions, and correspondence while leveraging AI tools to enhance efficiency.

Responsibilities

• Evaluate dispute eligibility against federal IDR requirements before anything gets filed
• Own submissions through the CMS portal: documentation, offer amounts, supporting briefs
• Monitor deadlines across active disputes and make sure nothing lapses on procedure
• Handle correspondence with payers and IDR entities, and track every follow-up to close
• Verify cases actually resolved, catching premature or missed closures before they cost us money
• Read 835 remittance files and EOBs to reconstruct what a payer actually did and why
• Turn every recurring pattern you spot into a spec, a checklist, or a prompt that makes the next case easier
• Work directly with AI tools to take the repetitive parts off your plate, then partner with engineering to make those improvements permanent

Skills

• 2 to 4 years in revenue cycle, claims operations, denials, appeals, or medical billing
• Comfortable reading EOBs, 835 remittance files, CPT codes, and claim adjustment reason codes
• Hands-on fluency with AI tooling (Claude, ChatGPT, or similar). You have used it to ship or accelerate real work, not just tried the demos
• Comfort with data and analytical tools (Excel or Sheets at pivot-table level, SQL a plus). You can pull answers yourself rather than filing a request
• Clear written communication. You can turn a messy situation into a crisp summary
• The ability to manage a lot of competing deadlines without dropping any of them
• A preference for small teams and early-stage chaos over mature org charts
• Sound judgment, operational depth, and ownership mindset are required
• Grit matters more than pedigree
• Direct experience with Independent Dispute Resolution, the No Surprises Act, arbitration, or out-of-network claims

Qualifications

Must Haves

• 2 to 4 years in revenue cycle, claims operations, denials, appeals, or medical billing
• Comfortable reading EOBs, 835 remittance files, CPT codes, and claim adjustment reason codes
• Hands-on fluency with AI tooling (Claude, ChatGPT, or similar). You have used it to ship or accelerate real work, not just tried the demos
• Comfort with data and analytical tools (Excel or Sheets at pivot-table level, SQL a plus). You can pull answers yourself rather than filing a request
• Clear written communication. You can turn a messy situation into a crisp summary
• The ability to manage a lot of competing deadlines without dropping any of them
• A preference for small teams and early-stage chaos over mature org charts
• Sound judgment, operational depth, and ownership mindset are required
• Grit matters more than pedigree

Nice to Haves

• Direct experience with Independent Dispute Resolution, the No Surprises Act, arbitration, or out-of-network claims