Arbitration Claims Specialist
$24 - $43 per hourUnitedHealthcare
Independent Dispute Resolution Team MemberThis position is National Remote. You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four days per week.At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.This role supports ClearHealth Strategies' Independent Dispute Resolution (IDR) team in a quasi-legal process focused on dispute review, eligibility analysis, and preparing arbitration briefs to ensure compliance with the federal No Surprises Act and state surprise billing laws.This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm depending on the local time zone. It may be necessary, given the business need, to work occasional overtime.Primary Responsibilities:Prepare arbitration briefsRespond to inquiries from CMS, arbiters, providers, clients, and ClearHealth managementIdentify issues, analyze EOBs and claim information, apply critical thinking skills to formulate plan of action, and resolve issues independentlyTriage complex issues to managementManage multiple priorities in a time sensitive mannerWork in fast-paced, high-volume environment with quick turnaround timeYou'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:High School Diploma / GED OR equivalent work experienceMust be 18 years of age OR older1+ years of experience preparing written summaries, case reviews, reports, or briefs in a regulated, compliance driven, or legal adjacent environment1+ years of experience reviewing and interpreting claims data, Explanation of Benefits, and supporting documentation to identify issues and determine appropriate next stepsExperience ensuring compliance with HIPAA privacy and security regulationsAbility to work full-time between 8:00 am - 5:00 pm local time, including the flexibility to work occasional overtime given the business needPreferred Qualifications:1+ years of experience working with the federal No Surprises Act (NSA) and/or state surprise billing disputesExperience supporting or working within personal injury litigationKnowledge of the medical claims processTelecommuting Requirements:Ability to keep all company sensitive documents secure (if applicable)Required to have a dedicated work area established that is separated from other living areas and provides information privacy.Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $24 - $43 hourly based on full-time employment. We comply with all minimum wage laws as applicable.Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. UnitedHealthcare
$50k - $62k
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$19 per hour
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