[Hiring] Arbitration Claims Specialist @UnitedHealth Group

Role Description

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 briefs
• Respond to inquiries from CMS, arbiters, providers, clients, and ClearHealth management
• Identify issues, analyze EOBs and claim information, apply critical thinking skills to formulate plan of action, and resolve issues independently
• Triage complex issues to management
• Manage multiple priorities in a time sensitive manner
• Work in fast-paced, high-volume environment with quick turnaround time

Qualifications

• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR older
• 1+ years of experience preparing written summaries, case reviews, reports, or briefs in a regulated, compliance driven, or legal adjacent environment
• 1+ years of experience reviewing and interpreting claims data, Explanation of Benefits, and supporting documentation to identify issues and determine appropriate next steps
• Experience ensuring compliance with HIPAA privacy and security regulations
• Ability to work full-time between 8:00 am - 5:00 pm local time, including the flexibility to work occasional overtime given the business need

Requirements

• 1+ years of experience working with the federal No Surprises Act (NSA) and/or state surprise billing disputes
• Experience supporting or working within personal injury litigation
• Knowledge of the medical claims process

Telecommuting 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

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)

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.