Arbitration Specialist II
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Job Description
Arbitration Specialist managing State and Federal healthcare dispute submissions for US Anesthesia Partners. Monitoring deadlines, filing cases, and maintaining arbitration records.
Responsibilities:
- Submit and manage out-of-network disputes through State and Federal independent dispute resolution/arbitration processes
- Monitor arbitration deadlines and ensure compliance
- Manage assigned dispute inventory regulated by Federal or State law
- Follow arbitration team pathways and standards
- Learn and apply State and Federal arbitration guidelines to assigned cases
- Support the Notice of Open Negotiation process for Federal disputes
- File State disputes through Department of Insurance portals and Federal disputes through the CMS portal
- Confirm required data is available for timely and accurate submissions
- File and respond to dispute/arbitration correspondence on time
- Respond to correspondence as directed by management
- Research and address inquiries from arbitrators
- Provide research-based answers to questions and concerns
- Maintain electronic case files and retained documents
- Communicate trends, issues, concerns, and deadlines to the arbitration management team
- Act as management point-of-contact support for assigned cases
- Maintain productivity and quality standards
- Assist with special projects and perform other assigned duties
- No direct reports
Requirements:
- High school diploma or equivalent
- 3–4 years of related experience
- Advanced skill in computer applications, including MS Word and MS Excel
- Intermediate skills in Microsoft Word and Excel required
- Advanced knowledge of managed care programs and healthcare billing
- Excellent written and verbal communication skills
- Ability to work independently with limited supervision
- Ability to communicate effectively in writing
- Ability to work a flexible schedule, including occasional weekends
- Knowledge of basic medical terminology and concepts preferred
- Knowledge of CPT, ICD-9, and ASA coding preferred
- Organized with strong attention to detail
- Ability to prioritize and organize work, meet deadlines, and work under pressure in a fast-paced environment
- Ability to type at least 35 wpm
- Must possess sufficient eye-hand coordination/manual dexterity to operate office equipment
- Required normal range of hearing and eyesight
- Ability to occasionally lift papers and boxes weighing up to 35 pounds
- Anesthesia experience preferred
- Prior collections experience and/or phone work is a plus
Benefits:
- Quarterly bonus eligibility (not guaranteed; based on company and individual performance)
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