IDR Arbitrator (Part-Time 20-25 hours per week)

Commence•Virginia Beach, VA
•$70 - $90•Remote

About The Position

At Commence, we’re the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient process to program and patient health. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care. With human-centered, healthcare-relevant, and value-based solutions, we create new possibilities with data. We provide proof beyond the concept and performance beyond the scope with a focus on efficiencies that transform the lives of those we serve. With a culture driven by purpose, straightforward communication and clinical domain expertise, Commence cuts straight to better care. Commence is seeking a highly skilled and detail-oriented Arbiter to join our team. The Arbiter will be responsible for arbitrating/deciding payment disputes, analyzing documentation, and managing case files. The ideal candidate has a strong understanding of Microsoft systems and excellent writing skills.

Requirements

  • Strong understanding of Microsoft systems
  • Excellent writing skills
  • Ability to perform comfortably in a fast-paced, deadline-oriented work environment
  • Excellent organizational, interpersonal, written, and communication skills
  • Ability to work as a team member, as well as independently
  • Work across multiple systems, such as SharePoint, Salesforce, and Microsoft Office products

Nice To Haves

  • Juris Doctorate preferred
  • Certified in Arbitration is preferred, required within the year

Responsibilities

  • Arbitrating/deciding payment disputes
  • Analyzing documentation
  • Managing case files
  • Review all dispute-relevant information; request additional information as authorized and required; decide as to whether the initiating party or non-initiating party will be awarded the arbitration decision
  • Remain neutral when analyzing the materials provided, and must be able to write a concise determination in a short period of time to meet deadlines
  • Review cases to determine and summarize facts of each case assigned and assess issues involved in the case
  • Collaborate with other technical and legal professionals, requesting and dispensing assistance as needed, verbally and in writing, to reach the most appropriate decision
  • Research jurisdictional and substantive issues using federal and state law and regulations as they pertain to the No Surprises Act of 2020 and the Federal Independent Dispute Resolution Entity program.
  • Interpret applicable regulations and policies associated with the case to determine the appropriate decision, both concerning jurisdiction and the merits
  • Communicate the determination in a clearly written format
  • Exercise independent judgment to ensure determination is accurate, well supported, and defensible; take appropriate action as required
  • Draft and/or edit and review determination decisions
  • Perform other duties as may be assigned by management

Benefits

  • Equal employment opportunity employer
  • Personnel processes are merit-based and applied without discrimination
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
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