Company: Sun Knowledge Pvt. Ltd. (https://sunknowledge.com)

Location: Kolkata, West Bengal

Department: US Healthcare Revenue Cycle Management (RCM)

Shift: Night Shift (US Business Hours)

Employment Type: Full-time

Job Summary

Sun Knowledge is looking for an experienced and result-oriented Manager – Independent Dispute Resolution (IDR) to lead and manage the IDR process within our US Healthcare RCM operations. The ideal candidate will have robust knowledge of the US No Surprises Act, IDR dispute management, payer negotiations, claims reimbursement, and team leadership.

The candidate will be responsible for managing end-to-end IDR operations, ensuring timely dispute submissions, improving reimbursement outcomes, maintaining regulatory compliance, and driving operational performance.

Key Responsibilities

- Lead and manage end-to-end Independent Dispute Resolution (IDR) operations for US Healthcare claims.
- Ensure compliance with the US No Surprises Act and applicable federal or state IDR requirements.
- Oversee the preparation, validation, submission, tracking, and resolution of IDR disputes.
- Manage dispute documentation, supporting medical records, claim details, payment information, and offer submissions.
- Monitor dispute timelines, submission deadlines, determinations, and payment follow-ups.
- Analyze payer reimbursement trends, claim underpayments, and dispute outcomes to identify opportunities for revenue improvement.
- Develop strategies to improve dispute success rates, reimbursement recovery, productivity, and turnaround time.
- Lead, mentor, and develop team leaders, SMEs, and IDR specialists.
- Establish and monitor KPIs, including productivity, quality, turnaround time, dispute success rate, and financial recovery.
- Coordinate with internal RCM teams, billing operations, AR follow-up, coding, and client stakeholders.
- Prepare and present operational dashboards, performance reports, root-cause analysis, and improvement plans.
- Ensure adherence to client SLAs, internal SOPs, quality standards,



and data confidentiality requirements.
- Drive process improvements, automation opportunities, and operational efficiencies.

Required Qualifications and Experience

- Graduate in any discipline; a degree in Healthcare Management, Business Administration, or a related field is preferred.
- Minimum 10–15 years of experience in US Healthcare RCM, with substantial exposure to IDR, out-of-network claims, or dispute resolution.
- At least 2–3 years of experience in a managerial or team leadership role.
- Strong understanding of the No Surprises Act, Federal IDR process, payer disputes, and out-of-network reimbursement.
- Hands-on experience with IDR case management, documentation, submission workflows, and determination tracking.
- Proven ability to manage teams, meet operational targets, and improve financial outcomes.
- Strong analytical, communication, problem-solving, and stakeholder management skills.
- Proficiency in MS Excel, reporting tools, and RCM workflow systems.

Preferred Skills

- Experience managing high-volume IDR operations for US Healthcare providers, physician groups, or revenue cycle organizations.
- Knowledge of IDR eligibility, open negotiation requirements, certified IDR entity workflows, and applicable submission deadlines.
- Experience with operational reporting, quality audits, process improvement, and client management.
- Exposure to multiple payer workflows and out-of-network claims management.

Shift and Work Location

- Work Location: Sun Knowledge, Kolkata, West Bengal.
- Shift: Night shift aligned with US business hours.
- Work Mode: As per company policy.

Why Join Sun Knowledge?

- Opportunity to lead and scale specialized US Healthcare RCM operations.
- Work with experienced healthcare operations professionals.
- Contribute to process optimization, revenue recovery, and operational excellence.
- Build a long-term career in a growing US Healthcare services environment.

Interested candidates can share their updated resumes highlighting their IDR experience, team-handling capabilities, and expertise in US Healthcare RCM.

📌 Manager US Healthcare (IDR) in Kolkata
🏢 Sunknowledge
📍 Kolkata