[Hiring] Subject Matter Expert, Independent Dispute Resolution @nimble

Role Description

The Subject Matter Expert (SME) for Dispute Resolution is a strategic individual contributor responsible for providing deep expertise across all aspects of independent dispute resolution billing, payment dispute resolution, and Independent Dispute Resolution (IDR) arbitration processes. This role requires a proven expert who can drive operational excellence, optimize reimbursement strategies, minimize revenue leakage, and ensure regulatory compliance in an increasingly complex healthcare payment landscape. The SME will work closely with cross-functional teams and leadership to advance nimble's independent dispute resolution business solutions.

• Serve as the primary subject matter expert for Independent Dispute Resolution, all aspects of the No Surprise Act, and state and federal Independent Dispute Resolution processes and regulations
• Provide expert guidance on independent dispute resolution, payment dispute resolution, payer relationship strategies, and negotiation approaches to maximize appropriate reimbursement
• Stay current on industry trends, regulatory changes, and emerging best practices in independent dispute resolution, revenue cycle management, and dispute resolution
• Provide consultative services to clients who receive nimble IDR services
• Provide sales support for future clients related to nimble IDR services

Qualifications

• Juris Doctorate Degree - Preferred, but equivalent expertise and experience considered
• Minimum of 5 years of hands-on experience in healthcare related regulatory space
• 2 years of experience with independent dispute resolution processes for providers or payers
• Strong analytic skills and proven success leading or supporting process improvement initiatives and project management
• Advanced knowledge of the revenue cycle required; experience with ASC billing preferred
• Experience in a complex healthcare environment with exposure to strategic planning and operational excellence

Requirements

• Deep subject matter expertise in independent dispute resolution billing, all aspects of the No Surprise Act, and state and federal Independent Dispute Resolution processes and regulations
• Proven experience and expertise in supporting organizational transformation and strategic alignment initiatives
• Experience contributing to product development, new product launches, and innovative solution design
• Demonstrated experience in financial analysis and planning
• Strong ability to identify and address client needs and support relationship development
• Intermediate to advanced level of expertise with Microsoft Office Suite and data analysis tools
• Knowledge of and ability to comply with HIPAA, HITECH, and patient confidentiality policies

Benefits

• Open to remote or in-office position (New York City)
• Reports to senior leadership in the IDR business
• Role requires travel to clients and company offices, approximately <20%

Key Competencies

• Drives Results: Consistently achieves results, even under difficult circumstances. Takes initiative and readily tackles challenges. Identifies and seizes new opportunities. Persists despite setbacks or obstacles.
• Communicates Effectively: Develops and delivers communications that convey a clear understanding of the unique needs of different audiences. Provides timely and helpful information across the organization. Encourages open expressions of diverse ideas and opinions. Adapts communication style to fit the situation.
• Quality Decision-making: Makes sound recommendations, even in the absence of complete information. Considers all relevant factors and uses appropriate decision-making criteria and principles. Shows courage in speaking up and driving appropriate recommendations based on sound risk/reward analysis.
• Client Centricity: Gains insight into customer needs. Identifies opportunities that benefit the customer. Contributes to solutions that meet customer expectations.
• Collaboration & Influence: Works effectively across organizational boundaries. Builds strong working relationships. Influences without direct authority. Partners effectively with diverse teams.