Arbitration Specialist

Elite Billing and Collections, LLC; Bloomfield (NJ); On-site; USD 65,000 - 90,000; Full time

Job summary

Elite Billing and Collections, LLC is seeking an Arbitration Specialist for a full-time, remote role overseeing arbitration and dispute resolution for out-of-network surgical claims. You will review claim files, payer determinations, and supporting documents to identify underpayments and prepare submissions.

You will coordinate with internal legal, coding, and billing teams, monitor deadlines, communicate with payers, and track case outcomes.

Qualifications

• Strong analytical and investigative skills to review complex claim data and identify reimbursement discrepancies.

Responsibilities

• Review claim files, payer determinations, and supporting documentation to identify underpayments and reimbursement issues.

Skills

Analytical skills

Investigative skills

Healthcare billing

No Surprises Act knowledge

Arbitration experience

Communication skills

Case management

Regulatory compliance

Documentation

Education

Associate or Bachelor’s degree in Healthcare Administration or related field

Tools

Spreadsheets

Case management software

Document management systems

Billing software

Job description

Company Description Elite Billing and Collections, LLC specializes in complex out-of-network surgical claims, with a strong focus on navigating the No Surprises Act and related regulations. The organization brings together experienced legal professionals, certified professional coders, and paralegals who excel at uncovering opportunities within intricate billing scenarios. By combining regulatory expertise with strategic claim management, the company aims to secure fair and maximum reimbursement for healthcare providers. Elite Billing and Collections positions itself as a forward-thinking leader in out-of-network billing, transforming regulatory challenges into competitive advantages. Team members join a growing organization committed to redefining success in surgical claims and reimbursement.

Role Description The Arbitration Specialist is a full-time, remotr role, responsible for managing arbitration and dispute processes for out-of-network surgical claims. In this role, the specialist reviews claim files, payer determinations, and supporting documentation to identify underpayments and reimbursement issues. The Arbitration Specialist prepares detailed arbitration submissions, drafts persuasive position statements, and compiles legal, clinical, and coding evidence to support claims. Daily tasks include coordinating with internal legal, coding, and billing teams; monitoring deadlines and regulatory requirements; communicating with payers and external parties; and tracking case outcomes in internal systems. The role also involves analyzing trends in disputes, contributing to process improvements, and supporting the development of strategies to maximize compliant reimbursement for clients.

Qualifications

• Strong analytical and investigative skills, including the ability to review complex claim data, interpret payer responses, and identify reimbursement discrepancies.
• Experience with healthcare billing, out-of-network claims, and familiarity with arbitration or dispute resolution processes; knowledge of the No Surprises Act or similar regulations is highly beneficial.
• Excellent written communication skills for drafting arbitration statements, summaries, and supporting documentation, along with clear, professional verbal communication for internal and external interactions.
• Ability to manage multiple cases simultaneously, prioritize deadlines, maintain accurate records, and work effectively in a fast-paced, detail-oriented environment.
• Proficiency with standard office and case management tools (e.g., spreadsheets, databases, document management systems) and comfort learning specialized billing or claims software.
• Collaborative mindset with the ability to work closely with legal, coding, and billing teams while exercising sound judgment and maintaining confidentiality.
• Relevant experience in medical billing, claims processing, legal support, or healthcare administration; prior work in arbitration, litigation support, or payer disputes is a plus.
• Associate or Bachelor’s degree in a related field such as Healthcare Administration, Legal Studies, Business, or equivalent practical experience preferred.