Overview
This role is for an Arbiter responsible for arbitrating/deciding payment disputes. The position involves analyzing dispute documentation, researching jurisdictional and substantive issues, and managing case files. The ideal candidate is detail-oriented, neutral in review, and able to produce concise written determinations on tight deadlines.
Responsibilities
- Arbitrating/deciding payment disputes; may also determine jurisdictional issues
- 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 materials
- Review assigned cases to determine and summarize relevant facts and assess issues involved
- Collaborate with technical and legal professionals by requesting and dispensing assistance as needed, verbally and in writing
- Research jurisdictional and substantive issues using federal and state law and regulations related to the No Surprises Act of 2020 and the Federal Independent Dispute Resolution Entity program
- Interpret applicable regulations and policies to determine appropriate decisions for both jurisdiction and merits
- Communicate determinations clearly in written format
- Exercise independent judgment to ensure determinations 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
- Primarily responsible for arbitrating/deciding payment disputes; may also determine jurisdictional issues
- Review dispute-relevant information and request additional information as authorized and required
- Write concise determinations within short timeframes to meet deadlines
- Remain neutral when analyzing materials
- Summarize facts and assess issues for assigned cases
- Communicate determinations in a clearly written format
Qualifications & Experience
- Juris Doctorate preferred
- Certified in Arbitration is preferred; required within the year
- Ability to perform comfortably in a fast-paced, deadline-oriented work 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 / Fit Considerations
- Schedules may vary and may include weekend and holiday shifts
- Requires established, professional relationships with internal personnel at all levels, and with beneficiaries, representatives, providers, and other stakeholders
Work Environment / Physical Demands
- Office/remote position
- Work is performed regularly in a climate-controlled environment
- Must be able 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
- Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions
Compensation & Benefits
- Not specified in the provided job description
Location
- Remote position (office/remote work environment)