Team Lead, Arbitration Services

Arbitration Services Team Lead

Company: Claritev
Location: Not Specified
Salary Range: $57,000 - $62,000

At Claritev, we pride ourselves on being a dynamic team of innovative professionals dedicated to bending the cost curve in healthcare. We are intentionally bold, foster innovation, nurture accountability, champion diversity, and empower each other. Join our transformational journey to become a leading voice in healthcare technology, data, and innovation.

Job Summary

This position oversees the Arbitration Services Team activities to ensure the team achieves and maintains service, production, and quality standards. You will collaborate with team members to foster growth and development. This role manages the arbitration services team inventory, including the evaluation of provider disputes and appropriate client payment offers. You will coordinate efforts with the team and other leadership to bring matters to efficient and successful outcomes.

Duties:

• Oversee the assigned arbitration services team to ensure tasks are completed within required regulatory timeframes while maintaining production standards and quality assurance.
• Ensure all client deliverables and SLAs are achieved. Provide exceptional results to clients' escalated inquiries, including root cause analysis.
• Track trends, initiate process improvements to eliminate impediments to delivering quality service, and ensure company and team goals are met.
• Ensure smooth and effective day-to-day team operations. Consistently report results to the leadership team.
• Establish, maintain, and monitor individual and departmental performance expectations/metrics, and implement measures to correct deficiencies. Consistently and thoroughly document employee progress.
• Assist in the development, implementation, and monitoring of department policies and procedures. Develop and implement system and operation changes to improve service and production efficiency. Assist with the creation, testing, and implementation of future automation and technical solution initiatives.
• Keep management abreast of key operation, personnel, and client issues.
• Select, develop, and evaluate staff to ensure the efficient operation of the department. Implement corrective action when deficiencies are identified.
• Collaborate with other departments to ensure the successful delivery of product expectations, including Service Operations, QA, TG&D, Legal, Sales and Account Management, Data Science, HCE, and IT.
• Respond timely to all electronic, written, and verbal communications, log information derived from written and verbal communication; maintain detailed and accurate records.
• Outreach to clients for data needed for arbitration packages and/or attend client meetings.
• Maintain sensitivity to privacy in accordance with HIPAA guidelines.
• Collaborate, coordinate, and communicate across disciplines and departments.
• Ensure compliance with HIPAA regulations and requirements.
• Demonstrate Company's Core Competencies and values.
• This position is considered a High Risk Role due to exposure to PHI sensitive data.

Job Scope:

Keep the needs of external and internal customers as a priority when making decisions and acting. Operates independently under limited supervision. Has decision-making authority within specified parameters and must engage advice and/or help of manager to proactively resolve cases. Works across customers, beneficiaries, providers, and supplemental payors while maintaining positive relationships. The incumbent must be open to feedback, teamwork, and show interest in contributing ideas to improve organizational processes. Guides others on the team, provides coaching, and prioritizes workload across the team.

Compensation:

• Salary Range: $57,000 - $62,000
• Specific offers consider candidate's education, experience, skills, work location, and internal equity.
• Eligible for health insurance, 401k, and bonus opportunity.

Qualifications:

Requirements:

• Minimum high school diploma or equivalent (GED) and two (2) years' experience in healthcare operations. Bachelor's degree in a related field is preferred plus two (2) years' experience in healthcare operations.
• Minimum 1 year management/leadership experience or 2 years in a senior role.
• Excellent organizational, analytical, and independent decision-making skills.
• Demonstrated critical thinking skills with 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.

Benefits:

• Competitive compensation and benefits packages.
• Incentive bonus program, recognition, and awards programs.
• Friendly and supportive work environment.
• Flexible schedules whenever possible.
• Wide range of live and web-based professional development and educational programs.

Your Benefits Will Include:

• Medical, dental, and vision coverage with low deductible & copay.
• Life insurance.
• Short and long-term disability.
• Paid Parental Leave.
• 401(k) + match.
• Employee Stock Purchase Plan.
• Generous Paid Time Off (accrued based on years of service).
• 10 paid company holidays.
• Tuition reimbursement.
• Flexible Spending Account.
• Employee Assistance Program.
• Sick time benefits (accrual rates may vary by state law).

EEO Statement:

Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations.