Job description
TASK SUMMARY
The No Surprises Act Arbitrator role is a 1099 position. Services are paid for on a per-case basis for contracting work completed.
The experienced Arbitrator makes the payment determination in the independent dispute resolution process between providers, facilities, providers of air ambulance services, out-of-network services, and excessive emergency room charges provided by group health plans, health insurance issuers, and Federal Employees Health Benefits (FEHB) Program carriers. The arbitrator makes the determinations based on the rules enacted under the No Surprises Act (NSA). The NSA process requires that the Entity determine a case's eligibility and whether any conflict of interest exists regarding the arbitrator selected for a particular dispute. The responsibilities of an arbitrator include analyzing information provided by the Parties to the dispute using knowledge of the NSA requirements and acceptable criteria under the NSA, and creating a report on the outcome of the arbitration process in accordance with the NSA requirements. There is no hearing component to these reviews; this is a strictly paper-based review process.
To be successful as an Arbitrator, you should have solid knowledge of healthcare-related payment determinations, sound organizational skills, and strong understanding of industry practices. Ultimately, a top-notch arbitrator must have the ability to remain neutral when analyzing the materials provided by the parties to the dispute and be able to write a concise decision in a short period of time. Prior experience with medical arbitration and/or dispute resolution is important. In the absence of No Surprises Act experience, preference will be given to arbitrators with AAA training and healthcare/insurance review experience.
Dane Street’s success relies on individual and team contributions every day. We care for our customers, each other, and Dane Street. It is the responsibility for all to maintain a positive working environment that promotes client satisfaction and results.
MAJOR DUTIES & RESPONSIBILITIES
Reviewing materials related to the dispute and any potential data related to the issues in question.
Provide a written decision rationale based on baseball arbitration processes.
Applying laws, procedures, and industry knowledge to settle disputes.
Obtain Dane Street training for the program and complete process review.
Submit reporting on Dane Street’s portal and submit billing on the completed review.
Turn-around all reviews in 5 days or less.
Requirements
EDUCATION/CREDENTIALS:
Law, business degree or extensive medical review experience
Solid knowledge of No Surprises Act procedures, policies, and law. Must have performed NSA reviews for an existing Independent Dispute Resolution Entity.
Demonstrate a neutral disposition.
Strong communication skills.
Good writing skills.
JOB RELEVANT EXPERIENCE:
Business experience in a healthcare and/or insurance setting is preferred. Prior IDR experience is necessary.
JOB RELATED SKILLS/COMPETENCIES:
Present exceptional communication skills with a clear understanding of the company's business lines. The ability to apply critical thinking, manage time efficiently and meet specific deadlines. Computer literacy and typing skills are essential.
WORK FROM HOME TECHNICAL REQUIREMENTS:
Supply and support their own internet services.
Maintaining an uninterrupted internet connection is a requirement for all work-from-home positions.
This job description is subject to change at any time.
Benefits
Originally posted on Himalayas
Who can apply
Eligible countries: United States. Accepted UTC offsets: UTC-10, UTC-9, UTC-8, UTC-7, UTC-6, UTC-5, UTC+14. Review the full description for employer-specific work authorization, residency and schedule requirements.