Arbitration Specialist - Formal No Surprises Act

Arbitration Specialist

The Arbitration Specialist is responsible for analyzing claims eligible for arbitration and reviewing, analyzing and reporting reimbursement integrity measures.

• Analyze claim reports to determine claims eligible for arbitration for both ERISA/NSA claims as well as state insurance department claims.
• Prepare claims for submission to the appropriate portals for arbitration.
• Have the ability for re-prioritizing key tasks and meet with manager and director to provide updates of findings and outcomes.
• Complete special projects and other duties as assigned.
• Strong computer skills including Microsoft Office with a strong proficiency in Excel spreadsheets, using formulas, pivot tables, filters, etc.
• Strong organizational, analytical, and problem‑solving skills.
• Knowledge of the insurance industry.
• Proven success in negotiation and technical writing.
• Professionalism in all dealings, both internal and external.
• Ability to clearly communicate, both verbally and in writing.
• Knowledge of medical terminology.
• Other duties as assigned.

• High School Diploma or equivalent is required.
• Medical Billing/Collections Management Experience is highly preferred.

• Knowledge of CPT.
• Knowledge of laws that regulate communication and privacy act.
• Understanding of HIPAA Laws.

• Must maintain professional appearance and be on-camera via Teams.
• Ability to be at work on a regular and consistent basis.
• Proficiency in using the computer as your primary tool for performing these job responsibilities is required.

• Fully Remote - Work from anywhere within the United States with reliable high‑speed internet but preference is to be based in, or around the Dallas, TX area.
• Multiple medical plan options.
• Health Savings Account with company contributions.
• Dental & vision coverage for you and your dependents.
• 401k with Company match.
• Vacation, sick time & Company paid holidays.
• Company wellbeing program with health insurance incentives.