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

Commence • Virginia Beach, VA

1d • 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
• Merit-based personnel processes
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

What This Job Offers

• Job Type: Part-time
• Career Level: Mid Level
• Education Level: Ph.D. or professional degree