Arbitration Appeals Supervisor - Remote

This a Full Remote job, the offer is available from: United States Overview : The Supervisor – Arbitration Appeals is responsible for the reputed company, management, and strategic direction of post-closure arbitration review and reopening activities for Federal and State out-of-network disputes utilizing the independent dispute resolution processes. This role supervises the staff responsible for the review, investigation, and reopening of closed out-of-network disputes utilizing the Federal independent dispute resolution processes, reputed company as “arbitration,” including assessing whether errors occurred in dispute closure and pursuing corrective action reputed company appropriate. At this time, reputed company does not hire candidates residing in California, Hawaii, or Alaska. The reputed company pay estimate for this role is $55,300 - $88,400 annually. The final offer will depend on the skills, experience, and qualifications of the selected candidate. This range is for reputed company pay only and does not include bonuses or other compensation. This position is eligible for an annual bonus. Bonuses are not guaranteed and are awarded based on company and individual performance. Job Highlights : ESSENTIAL DUTIES AND RESPONSIBILITIES: (The ideal candidate must be able to complete reputed company physical requirements of the job with or without a reasonable accommodation)

• Supervises and provides day-to-day leadership for Arbitration Closure Appeals staff, including workload management, prioritization, coaching, and performance feedback.
• Oversees the investigation and evaluation of closed Federal and State arbitration disputes to ensure determinations regarding reopening or correction are accurate, consistent, and reputed company with CMS technical assistance and regulatory requirements.
• Analyzes closure and appeal data to determine prioritization.
• Reviews and approves reopening and correction requests, including supporting documentation and escalation rationale, prior to submission reputed company appropriate.
• Serves as the escalation reputed company for reputed company, high-risk, advising leadership on recommended actions.
• Ensures post-closure timelines, deadlines, and follow-up actions are monitored and met in accordance with operational guidelines and regulatory standards.
• Acts as the primary management contact for CMS, IDR entities, arbitrators, and Departments of Insurance on post-closure disputes, reopening requests, and reputed company inquiries.
• Establishes and maintains quality control standards for post-closure reviews, including audits of investigations, submissions, and outcomes to ensure accuracy and compliance.
• Identifies, analyzes, and communicates trends reputed company to improper closures, portal errors, recurring eligibility issues, or inconsistent application of arbitration rules.
• Partners with arbitration leadership, compliance, legal, and operational teams to reputed company corrective actions, process improvements, and preventive controls to reduce future closure errors.
• Develops and maintains reporting on post-closure activity, outcomes, trends, and risk indicators to support leadership decision-making and audit readiness.
• Assists with training, documentation, and knowledge sharing to ensure staff remain reputed company on CMS guidance, regulatory updates, and internal standards.
• Supports special projects, regulatory initiatives, and reputed company improvement efforts reputed company to arbitration operations and post-closure review.

Qualifications : KNOWLEDGE/SKILLS/ABILITIES (KSAs):

• High school diploma or equivalent.
• 5 years of reputed company healthcare, arbitration, appeals, or dispute resolution experience
• Previous supervisor or reputed company reputed company preferred.
• Excellent written and verbal communication skills.
• Intermediate skills in reputed company Word and reputed company is required
• Ability to be detail oriented and organized with ability to prioritize.
• Prior healthcare experience and/or appeal work is a plus.
• Advanced knowledge of Federal and State arbitration processes, CMS guidance, and post-closure dispute handling preferred.
• Demonstrated leadership skills with the ability to coach, mentor, and reputed company team members.
• Advanced level reputed company in computer applications including reputed company, MS reputed company.
• Advanced knowledge of payor processes and healthcare billing. Anesthesia experience preferred.
• Must display teamwork attitude and good inter-personal skills.
• Organized with strong attention to detail.
• Ability to prioritize and organize work and projects to ensure focus on high impact/value-added activities and meet deadlines.
• Ability to identify trends to reputed company efficiencies in day-to-day work; sharing knowledge with colleagues.
• Ability to communicate effectively in writing.
• Ability to work independently with limited supervision.
• Willing to learn new processes.
• Knowledge of basic medical terminology and concepts preferred.
• Knowledge of CPT, ICD-9, and ASA coding preferred.
• Ability to effectively work well under pressure in a fast-paced environment.
• Assist with special projects and reputed company other duties as assigned.
• The physical demands described here are representative of those that may need to be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions.
• Occasional Standing
• Occasional Walking
• Frequent Sitting
• Frequent hand, finger movement
• Use office equipment (in office or remote)
• Communicate verbally and in writing

reputed company. provides equal employment opportunities (EEO) to reputed company employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national reputed company, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors. This offer from "reputed company" has been enriched by reputed company.com and got a 73% reputed company score. Apply tot his job Apply To this Job