Arbitration Services Team Lead
At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.
Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
JOB SUMMARY
This position oversees the Arbitration services team activities to ensure the team achieves and maintains service, production, and quality standards. Collaborate with team members to foster growth and development. This role manages the arbitration services team inventory including evaluation of provider disputes and appropriate client payment offers. The incumbent 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 the tasks completed by employees are within the required regulatory timeframe while maintaining production standards and quality assurance.
2. Ensure all client deliverables and SLA's are achieved. Providing exceptional results to clients escalated inquiries, to include root cause analysis.
3. Track trends, initiate process improvements to eliminate impediments to delivering quality service and ensure company and team goals are met.
4. Ensure smooth and effective day-to-day team operations. Consistently reporting results to the leadership team.
5. Establish, maintain, and monitor individual and departmental performance expectations/metrics and implement measures to correct deficiencies. Consistently and thoroughly document employee progress.
6. 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 of the department. Assist with the creation, testing and implementation of future automation and technical solution initiatives.
7. Keep management abreast of key operation, personnel, and client issues.
8. Select, develop, and evaluate staff to ensure the efficient operation of the department. Implement corrective action when deficiencies are identified.
9. Collaborate with other departments to ensure the successful delivery of product expectations to include Service Operations, QA, TG&D, Legal, Sales and Account Management, Data Science, HCE and IT.
10. Respond timely to all electronic, written, and verbal communications, log information derived from written and verbal communication; maintain detailed and accurate records.
11. Outreach to clients for data needed for arbitration packages and/or attend client meetings.
12. Sensitivity to privacy in accordance with HIPAA guidelines
13. Collaborate, coordinate, and communicate across disciplines and departments.
14. Ensure compliance with HIPAA regulations and requirements.
15. Demonstrate Company's Core Competencies and values held within.
16. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned, as necessary.
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 the others on the team, provides coaching, provides, and prioritizes workload across the team.
COMPENSATION
The salary range for this position is $57-62K. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also 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. Bachelors' 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 judgement.
* 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
* Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier, and telephone.
BENEFITS
We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.
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
- WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service
- 10 paid company holidays
- Tuition reimbursement
- Flexible Spending Account
- Employee Assistance Program
- Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits
EEO STATEMENT
Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please click here.
APPLICATION DEADLINE
We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.
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