Temporary No Surprises Act (NSA) Operations Specialist
Providence, Rhode Island, United States · Hybrid
Mid level
Please email [email protected] if you are a candidate seeking a reasonable accommodation for the application and/or interview process. At BCBSRI, our greatest resource is our people. We come from varyi…
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Full-time, Temporary
bachelor degree
Flexible work arrangements, Paid time off, Tuition reimbursement, Student-loan repayment, Health insurance, Dental insurance
Posted 19d ago
~40 hrs/week
Responsibilities
Provide operational support for No Surprises Act processes, focusing on case tracking and documentation for open negotiations and independent dispute resolutions. The role involves analyzing dispute determinations, tracking key metrics, and collaborating cross-functionally to ensure timely payments.
Requirements
Requires two to four years of experience in health plan operations and proficiency in Excel. A bachelor's degree in Healthcare Administration, Business, or Public Health and direct experience with the No Surprises Act are preferred.
Full job description
Please email HR_Talent_AcquisitionTeam@bcbsri.org if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
At BCBSRI, our greatest resource is our people.
We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.
We recognize that to do your best work, you have to be your best self. It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.
Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued.
Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.
We’re dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.
Why this job matters:
This temporary role provides operational support for No Surprises Act (NSA) processes, including open negotiation and independent dispute resolution activities. The role focuses on case tracking, documentation, and coordination to ensure timely and accurate processing during periods of increased volume.
What you will do:
Support NSA-related activities for Network Contracting.
Maintain documentation and continuous tracking of cases specific to negotiations and offers for the Open Negotiation Notification and Independent Dispute Resolution (IDR) intake processes.
Open Negotiation Notification (ONN)
Review and prepare offers during the open negotiation period.
Independent Dispute Resolution (IDR)
Prepare dispute documentation (e.g., Qualifying Payment Amount rationale)
Work in collaboration with administrative staff to ensure IDR payments are submitted timely
Work cross-functionally with GAU and Operations teams
Identify cases that may not qualify and escalate for review
Analyze dispute determinations
Track key metrics (IDR volume, outcomes, turnaround time, financial impact)
Compile data and assist in reporting and analysis
What you need to succeed:
Two to four years of experience in health plan operations
Strong analytical, organizational, operational and communication skills
Ability to manage multiple priorities in a fast-paced, regulatory environment
Ability to organize work efficiently to meet established time and quality standards
Proficient in Excel
The extras:
Bachelor’s degree in Healthcare Administration, Business, Public Health, or related field
Direct experience with the No Surprises Act, IDR, or out-of-network reimbursement
Proficient in Outlook
Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
In-office: onsite 5 days per week
Hybrid: onsite 2-4 days per week
Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia
Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today’s healthcare industry. BCBSRI is an equal opportunity employer.
A nonprofit health insurer helping all Rhode Islanders live their healthiest lives.
Industry
Insurance
Company size
501-1,000 employees
Founded
1939
Headquarters
Providence, Rhode Island
LinkedIn followers
20,816
At Blue Cross & Blue Shield of Rhode Island (BCBSRI), we know that health is more than what happens at the doctor’s office. Our vision is to improve health and well-being by leading access to high-quality, affordable, and equitable care. That means focusing on innovation, from opening retail stores across the state to expanding access to behavioral health services to helping address food insecurity among our neighbors.
BCBSRI is connected nationwide as an organization of 33 independent Blues plans, working locally and together to transform care from the ground up and serve members wherever they are. Whether you're an individual looking to join our team or an employer looking to protect your employees' health, let's work together to make a difference.
BCBSRI is an independent licensee of the Blue Cross and Blue Shield Association.
Offices: 500 Exchange Street, Providence, Rhode Island 02903, US
How many Administrative jobs are open in Providence, RI right now?
There are currently 272 open administrative positions in Providence, RI listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Administrative roles in Providence, RI?
Companies currently hiring include Brown Medicine, Care New England, The Warren Alpert Medical School of Brown University, Johnson & Wales University (JWU) - North Miami, Family Service of Rhode Island, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Administrative jobs in Providence, RI?
Yes — 47 of the 272 open administrative positions offer remote or hybrid work (11 remote, 36 hybrid).
How do I apply for Administrative jobs in Providence, RI?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.