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UnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of
Arbitration Claims Specialist
Location
United States
Posted
95 days ago
Salary
$24 - $43 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Arbitration Claims Specialist
UnitedHealth Group
Role Description This 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 (4) days per week. 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. - 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 - Work full-time between 8:00 am - 5:00 pm local time, including the flexibility to work occasional overtime given the business need Preferred Qualifications - 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. Soft Skills - Communicates clearly and professionally, with strong business writing skills - Effectively prioritizes tasks and manages workload to meet deadlines and goals - Works collaboratively and contributes positively to a team environment - Demonstrates a proactive, “ready to work, ready to learn” mindset - Upholds integrity, accountability, and strict confidentiality 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.
Job Requirements
- 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
- Work full-time between 8:00 am - 5:00 pm local time, including the flexibility to work occasional overtime given the business need
- Preferred Qualifications
- 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.
- Soft Skills
- Communicates clearly and professionally, with strong business writing skills
- Effectively prioritizes tasks and manages workload to meet deadlines and goals
- Works collaboratively and contributes positively to a team environment
- Demonstrates a proactive, “ready to work, ready to learn” mindset
- Upholds integrity, accountability, and strict confidentiality
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.
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