Dispute Resolution Specialist

Imagine360 • ,

2d • Remote

About The Position

Imagine360 is seeking a Dispute Resolution Specialist to serve as the primary resource for research, strategy, communication, and other matters related to Independent Dispute Resolution (IDR). The specialist will coordinate with the team and leadership to achieve efficient and successful outcomes and oversee intake, processing, and coordination of materials and information as regulated by federal or state law. The position is 100% remote.

Requirements

• At least 1 year of experience in healthcare operations relating to the No Surprises Act or Independent Dispute Resolution.
• Excellent organizational, analytical, and independent decision-making skills.
• Demonstrated problem-solving skills and the ability to manage multiple priorities and meet associated timelines.
• Ability to anticipate needs and solve problems proactively in a fast-paced, rapidly changing environment.
• Sound business judgment.
• Ability to learn quickly and work independently within time constraints.
• Adept knowledge of Microsoft Word, Excel, and Outlook.
• Logical, clear, and concise written and verbal communication skills.

Responsibilities

• Prepare written analyses of disputed health plan positions and persuasively document arguments supporting client positions in arbitration packages pursuant to federal regulations.
• Conduct due diligence to assist with analysis and preparation of arbitration packages.
• Work with other departments to develop or obtain information necessary for IDR package submissions.
• Review and analyze clinical information and documents submitted by providers, including materials of moderate to high complexity.
• Meet federal filing deadlines and turnaround times.
• Maintain detailed and accurate records.
• Maintain department productivity and quality standards.
• Collaborate, coordinate, and communicate across disciplines and departments.
• Ensure compliance with HIPAA regulations and requirements.
• Perform other IDR-related duties or responsibilities as required or assigned.

Benefits

• Multiple health plan options.
• Company-paid employee premiums for disability and life insurance.
• Parental leave policy.
• 20 days of PTO to start and 10 paid holidays.
• Tuition reimbursement.
• 401(k) company contribution.
• Company-paid short- and long-term disability and life insurance.
• Professional development initiatives and continuous learning opportunities.
• Opportunities to participate in and support the company's diversity and inclusion initiatives.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed