Arbitration Specialist III - Remote

Employer Industry: Healthcare Services

• Opportunity for career advancement and growth within the organization
• Competitive salary with potential for bonuses
• Supportive and collaborative work environment
• Chance to make a positive impact on dispute resolution and compliance processes
• Work independently with a focus on high-value activities
• Engaging in continuous learning and skill development

• Investigate closed Federal and State arbitration disputes to determine whether an error occurred in the dispute closure
• Analyze case details, submission history, portal activity, correspondence, and determinations to assess compliance with CMS technical assistance
• Prepare, document, and submit reopening or correction requests with supporting documentation
• Monitor and manage post-closure timelines and deadlines for reopening requests and corrections
• Serve as a primary resource for post-closure dispute review and advise management on case escalations

• High school diploma or equivalent
• 3-4 years of related experience
• Excellent written and verbal communication skills
• Intermediate skills in Microsoft Word and Excel
• Ability to work independently with limited supervision

• Prior healthcare experience and/or experience with appeals work
• Advanced knowledge of payor processes and healthcare billing
• Familiarity with basic medical terminology and concepts
• Knowledge of CPT, ICD-9, and ASA coding

#Healthcare Services #Dispute Resolution #Career Opportunity #Compliance #Healthcare Billing

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