Arbitrations Specialist

OrthoMed Anesthesia; Addison (TX); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(k) with 3% company contributions

Professional development opportunities

Collaborative team environment

Job summary

OrthoMed Anesthesia seeks an Arbitration Specialist to manage NSA-related disputes and ensure compliant billing practices at our Addison, TX office. You will navigate complex arbitration cases, review bills and claims, and collaborate with providers and insurers to resolve disputes.

The role emphasizes expertise in arbitration within healthcare, NSA regulations, and revenue cycle management, with on-site requirements and opportunities for professional development.

Qualifications

• Bachelor's degree or equivalent experience in healthcare-related field.
• 3-5 years in healthcare billing or revenue cycle management.
• Strong knowledge of the No Surprises Act and its billing implications.
• Experience with arbitration or mediation in healthcare settings.
• Familiarity with medical coding and insurance claim procedures.

Responsibilities

• Manage arbitration process for No Surprises Act disputes.
• Review medical bills, claims, and payments for arbitration prep.
• Collaborate with providers, insurers, and arbitrators to resolve disputes.
• Ensure NSA compliance in all arbitration proceedings.
• Present arguments and evidence during hearings.
• Maintain detailed records of arbitration cases and outcomes.
• Stay updated on NSA changes and industry practices.
• Educate internal teams on NSA compliance and arbitration processes.
• Develop strategies to minimize arbitration through proactive billing.

Skills

Arbitration skills

NSA regulations knowledge

Healthcare billing

Revenue cycle management

Medical coding knowledge

Education

Bachelor's degree in Healthcare Administration, Business, or relevant field

Tools

Billing software

Claims processing systems

Job description

The Arbitration Specialist role is essential for managing billing disputes and ensuring compliance with the No Surprises Act (NSA) regulations. This position requires a deep understanding of healthcare billing practices, particularly in anesthesia, and strong arbitration skills to navigate complex cases. This is a full-time position based at our corporate office in Addison, TX, reporting to the VP of Revenue Cycle Management. The role requires on-site presence during regular business hours.

Key Responsibilities

• Manage and oversee the arbitration process for disputes related to the No Surprises Act
• Review and analyze medical bills, insurance claims, and payment data to prepare for arbitration cases
• Collaborate with healthcare providers, insurers, and arbitrators to resolve billing disputes
• Ensure compliance with NSA regulations and guidelines in all arbitration proceedings
• Prepare and present compelling arguments and evidence during arbitration hearings
• Maintain detailed records of arbitration cases and outcomes
• Stay updated on changes to NSA regulations and industry best practices
• Provide guidance and education to internal teams on NSA compliance and arbitration processes
• Develop strategies to minimize the need for arbitration through proactive billing practices

Qualifications

• Bachelor's degree in Healthcare Administration, Business, or relevant job experience
• Minimum of 3-5 years of experience in healthcare billing, revenue cycle management, or related field
• Strong understanding of the No Surprises Act and its implications on medical billing
• Experience with arbitration or mediation processes, preferably in healthcare
• Knowledge of medical coding, billing practices, and insurance claim procedures
• Familiarity with anesthesia billing and practice management is a plus

At OrthoMed, you'll be part of a team dedicated to excellence in patient care. We offer competitive compensation, health/dental/vision insurance, 401(k) with 3% non-discretionary company contributions, professional development opportunities, and a fun collaborative work environment.

• competitive compensation
• health/dental/vision insurance
• 401(k) with 3% non-discretionary company contributions
• professional development opportunities
• a fun collaborative work environment