About Us:

New York Plastic Surgical Group (NYPS Group) is the largest and longest-running private and academic plastic surgery practice in the United States. With more than 20 board-certified plastic surgeons practicing across 10+ affiliated offices, ambulatory surgery centers, and over 20 hospitals, NYPS Group provides expert, comprehensive, and compassionate care. Founded in 1948, NYPS Group, a division of Long Island Plastic Surgical Group, is one of the nation's most well-established plastic surgery practices, offering patients the collective expertise of specialty-trained surgeons dedicated to achieving exceptional outcomes.

Job Summary:

The Independent Dispute Resolution (IDR) Billing Specialist is responsible for identifying, preparing, and submitting out-of-network medical claims for dispute through both New York State and Federal IDR processes. This role requires comprehensive knowledge of surprise billing regulations, payer reimbursement methodologies, and the administrative requirements associated with open negotiation and formal IDR submissions. The specialist independently evaluates claim eligibility, prepares complete dispute submissions, develops supporting reimbursement narratives, and manages cases through the resolution process to ensure timely and successful outcomes.

Required Experience:

Minimum of 2-3 years of experience in medical billing, reimbursement, revenue cycle management, or healthcare claims dispute resolution Strong knowledge of the Federal No Surprises Act IDR process and New York State IDR regulations. Demonstrated experienceidentifyingand pursuing IDR-eligible claims for out-of-network providers. Proficiencyin preparing and submitting DOL Open Negotiation Notices and formal IDR applications. Experience assembling, organizing, andsubmittingcomplete dispute packets with supporting documentation. Strong analytical skills with the ability to interpret Explanation of Benefits (EOBs), payer policies, contracts, and reimbursement methodologies. Ability to work independently while effectively managing a high volume of cases and strict filing deadlines. Excellent written communication skills, including the ability to develop persuasive reimbursement narratives. Proficiencywith medical billing systems, claims management platforms, and documentation review processes. Strong organizational skills and attention to detail.

Education Requirement:

Associate's degree in healthcare administration, Business Administration, Medical Billing & Coding, or related field preferred. High School Diploma/GEDrequired. Equivalent experience in medical billing, revenue cycle management, or healthcare reimbursement may substitute for formal education. This will give you the largest qualified candidate pool while still reflecting the specialized nature of the role.

WHAT WE OFFER

Comprehensive Health Benefits:

Medical,Dental, andVision Coverage.

Voluntary Benefits:

Options include Aflac (short-term disability, hospital, accident, and cancer coverage), long-term disability, life insurance, and pet insurance.

Paid Time Off:

19 PTO days per year, in addition to 8 paid holidays.

Retirement Benefits:

401(k) plan with a discretionary company match.

Cosmetic & Med Spa Perks:

Employee discounts on services and products at Deep Blue Med Spa. 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