Arbitration Specialist - MPOWERHealth

HaloMD

We are a fast-growing arbitration/medical billing company looking for a positive person who is interested in being a success and will help take the company to the next level. The seasoned professional for this job needs superior communication and computer skills including familiarity, with Microsoft Outlook, Word and Excel.  This individual specializes in the resolution of arbitration negotiations, schedule arbitration teleconferences, and performs a wide variety of tasks such as generating reports, correspondence, and setting up informal offers.

Benefits:

• 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

Job Summary

The Arbitration Specialist is responsible for analyzing claims eligible for arbitration. This individual should possess superior communication and computer skills including familiarity, Microsoft Outlook, Word and Excel. This individual will review, analyze and report 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
• Work with external vendors such as State Department of Insurance (DOI) personnel and arbitrators to assist with issues and resolutions
• Complete special projects and other duties as assigned
• Strong computer skills including Microsoft Office with a strong proficiency in Excel spread sheets, 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

• Education and/or Experience

   

  • High School degree or equivalent
  • Minimum of 3 years Medical Billing/Collections Management Experience

   

• Skills/Specialized Knowledge

   

  • Knowledge of CPT
  • Knowledge of laws that regulates communication and privacy act. HIPAA laws and understanding of the application of all above

   

   

  Other Requirements

   

  • Must maintain professional appearance.
  • Ability to be at work on a regular and consistent basis

   

   

  It is the policy of HaloMD not to discriminate against any applicant for employment, or any employee because of age, color, sex, disability, national origin, race, religion, or veteran status.

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