Provider Dispute & NSA Adjuster (remote) at Evry Health in Remote

The Provider Dispute & NSA Adjuster is responsible for the end-to-end management of provider dispute resolution, with a strong focus on Texas open negotiation (Chapter 1467) and the No Surprises Act (NSA) Independent Dispute Resolution (IDR) framework within a commercial health plan environment. This role requires deep expertise in open negotiation and IDR processes, serving as a subject matter expert and key resource for complex out-of-network dispute resolution. You’ll also identify trends in disputes and partner closely with Claims, Customer Service, and Compliance to improve workflows, reduce errors, and strengthen the overall claims process. This role plays a critical role in ensuring accurate, compliant, and timely resolution of provider disputes while driving continuous process improvement at Evry Health. While this is a remote role, you must reside in the United States and in the Eastern or Central time zone. About Evry Health and Globe Life We are on a mission to bring humanity to health insurance. Our high-technology health plans expand benefits, increase access and transparency, and feature a personalized, human approach. We strive to ensure members live happier, healthier lives. Evry Health is the major medical division of Globe Life (NYSE:GL). Globe Life has 16.8 million policies in force, and more than 3,000 corporate employees and 15,000 agents. For more than 45 consecutive years, Globe Life has earned an A (Excellent) rating or higher from A.M. Best Company. The Provider Dispute & NSA Adjuster is responsible for the end-to-end management of provider dispute resolution, with a strong focus on Texas open negotiation (Chapter 1467) and the No Surprises Act (NSA) Independent Dispute Resolution (IDR) framework within a commercial health plan environment. This role requires deep expertise in open negotiation and IDR processes, serving as a subject matter expert and key resource for complex out-of-network dispute resolution. You’ll also identify trends in disputes and partner closely with Claims, Customer Service, and Compliance to improve workflows, reduce errors, and strengthen the overall claims process. This role plays a critical role in ensuring accurate, compliant, and timely resolution of provider disputes while driving continuous process improvement at Evry Health. While this is a remote role, you must reside in the United States and in the Eastern or Central time zone. About Evry Health and Globe Life We are on a mission to bring humanity to health insurance. Our high-technology health plans expand benefits, increase access and transparency, and feature a personalized, human approach. We strive to ensure members live happier, healthier lives. Evry Health is the major medical division of Globe Life (NYSE:GL). Globe Life has 16.8 million policies in force, and more than 3,000 corporate employees and 15,000 agents. For more than 45 consecutive years, Globe Life has earned an A (Excellent) rating or higher from A.M. Best Company.