Arbitration Specialist III

Job Summary

A company is looking for an Arbitration Specialist III to review and investigate closed out-of-network disputes through arbitration processes.

Key Responsibilities

• Investigates closed Federal and State arbitration disputes for errors in dispute closure
• Prepares and submits reopening or correction requests with necessary documentation
• Monitors post-closure timelines and advises management on case escalations and next steps

Required Qualifications

• High school diploma or equivalent
• 3-4 years of related experience
• Intermediate skills in Microsoft Word and Excel
• Advanced knowledge of payor processes and healthcare billing
• Prior healthcare experience and/or appeal work is a plus