Overview
The organization is seeking a highly skilled, detail-oriented Arbiter to arbitrate/decide payment disputes. This role involves analyzing dispute documentation, researching applicable legal and regulatory issues, drafting concise determinations, and managing case files while maintaining neutrality and meeting deadlines.
Responsibilities
- Primarily arbitrating/deciding payment disputes, including determining jurisdictional issues as applicable
- Review all dispute-relevant information; request additional information as authorized and required
- Decide whether the initiating party or non-initiating party will be awarded the arbitration decision
- Remain neutral when analyzing provided materials
- Write concise determinations within short timeframes to meet deadlines
- Review assigned cases to determine and summarize facts and assess issues involved
- Collaborate with other technical and legal professionals, requesting and dispensing assistance as needed (verbally and in writing)
- Research jurisdictional and substantive issues using federal and state law and regulations as they pertain to the No Surprises Act of 2020 and the Federal Independent Dispute Resolution Entity program
- Interpret applicable regulations and policies to determine the appropriate decision (jurisdiction and merits)
- Communicate determinations in a clearly written format
- Exercise independent judgment to ensure decisions are accurate, well supported, and defensible; take appropriate action as required
- Draft and/or edit and review determination decisions
- Perform other duties as assigned by management
Requirements
- This role is primarily responsible for arbitrating/deciding payment disputes, but may also determine jurisdictional issues
- Review all dispute-relevant information; request additional information as authorized and required
- Must remain neutral when analyzing materials provided
- Ability to write a concise determination in a short period of time to meet deadlines
- Ability to review cases, summarize facts, and assess issues involved
- Ability to collaborate with technical and legal professionals to reach the most appropriate decision
- Research jurisdictional and substantive issues using federal and state law and regulations as they pertain to the No Surprises Act of 2020 and the Federal Independent Dispute Resolution Entity program
- Interpret applicable regulations and policies associated with cases to determine the appropriate decision (jurisdiction and merits)
- Communicate determinations in a clearly written format
- Exercise independent judgment to ensure determinations are accurate, well supported, and defensible
- Draft and/or edit and review determination decisions
- Work comfortably in a fast-paced, deadline-oriented environment
- Excellent organizational, interpersonal, written, and communication skills
- Ability to work as a team member and independently
- Ability to work across multiple systems, such as SharePoint, Salesforce, and Microsoft Office products
Preferred Qualifications
- Juris Doctorate
- Certified in Arbitration (preferred; required within the year)
Work Schedule & Work Environment
- Schedules may vary and may include weekend and holiday shifts
- Office/remote position
- While performing duties, the employee regularly works in a climate-controlled environment
- Ability to sit, read, work on a computer, and watch a computer screen for extended periods of time
- Occasionally required to stand, walk, use hands and fingers, kneel or crouch
Additional Considerations
- This position requires established, professional relationships with internal personnel at all levels within the organization and with beneficiaries, representatives, providers, and other stakeholders.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.
Compensation & Benefits
- Not specified in the provided job description.
Equal Employment Opportunity
- The employer is an Equal Employment Opportunity employer; all personnel processes are merit-based and applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military and veteran status, or any other characteristic protected by applicable law.