Arbitration Manager

Position Title: Arbitration Manager Position Summary: Seasoned and results-driven professional with extensive experience in arbitration management, project oversight, and leadership.
Possesses exceptional communication and computer skills, including proficiency in Microsoft Outlook, Word, and Excel, with a strong focus on spreadsheet management and project coordination.
Recognized for the ability to meet deadlines, deliver results, and ensure compliance with state and federal regulations, including a comprehensive understanding of the No Surprises Act.
Adept at analyzing claim reports, preparing claims for arbitration, and collaborating with external stakeholders to resolve issues effectively.
Committed to maintaining high standards of ethical business conduct and serving as a positive role model for the team.
Reporting directly to the VP of Revenue Cycle Management, this role is instrumental in supervising the reimbursement team, driving operational efficiency, and achieving organizational goals.
Key Duties and Responsibilities: Analyze claim reports to identify eligible claims for arbitration, ensuring compliance with ERISA/NSA and state insurance department regulations.
Prepare and submit claims for arbitration through appropriate portals, maintaining meticulous attention to detail and accuracy.
Collaborate with external vendors, such as State Department of Insurance personnel and arbitrators, to address issues and facilitate resolutions.
Oversee and prioritize key tasks, providing regular updates to the Director of Revenue Cycle Management.
Conduct analysis of IDR, Arbitration, and Informal Teleconference processes, identifying opportunities for improvement and optimization.
Maintain effective communication with internal departments to obtain and analyze patient information for billing purposes.
Supervise arbitration personnel, including work allocation, training, and performance evaluation, fostering a culture of accountability and continuous improvement.
Provide training for new and existing billing staff on operating policies, protocols, and procedures, ensuring alignment with organizational standards.
Coordinate team member schedules to minimize operational disruptions and maintain productivity levels.
Conduct employee relations functions, including interviews, hiring, performance reviews, and terminations, in accordance with company policies and procedures.
Skills and Qualifications: Proficient in Microsoft Office suite, particularly Excel, with expertise in spreadsheet management, formulas, pivot tables, and filters.
Strong organizational, analytical, and problem-solving skills, with a keen attention to detail.
In-depth knowledge of the insurance industry, including understanding of CPT codes, HIPAA laws, and medical terminology.
Excellent verbal and written communication skills, with a professional demeanor in all interactions.
Advanced project management capabilities, including the ability to prioritize tasks, manage deadlines, and drive deliverables.
Minimum of 5 years of experience in Medical Billing/Revenue Cycle Management, with a track record of success in similar leadership roles.
Physical Demands: Ability to lift a maximum of 25 pounds.
Comfortable sitting for long periods of time, as required for the role.
Education: Bachelor's degree Conclusion: This enhanced resume showcases a candidate with a strong background in arbitration management, project oversight, and leadership, equipped with the skills and experience necessary to excel in the role of Arbitration Manager.
With a focus on spreadsheet management, project coordination, and compliance with state and federal regulations, this candidate is poised to drive operational efficiency and achieve organizational objectives effectively.