POSITION OVERVIEW:

The Claims Settlement Coordinator supports the Claims Settlement Team through leading the review and response to disputed claims submitted through state and federal arbitration processes. The Claims Settlement Coordinator will be responsible for supporting settlement offers and pricing after disputes have been filed to federal and state arbitrations, packaging and summarizing objective data and the arguments in support.

This position is FULLY REMOTE, but candidates must live within a 100 mile radius of St Petersburg, FL, as there may be a requirement to go on-site for team outings once a quarter.

KEY RESPONSIBILITIES:

- Prepares and presents response packages to cases submitted for arbitration/mediation at both the state and federal level under the NSA

- Provide input and guidance on the selection process for certified arbitration entities under the NSA

- Create a scalable IDR/Arbitration defense package through improved automation in the
creation and compilation of the necessary data elements

- Ensure Claims Settlement processes deliver required information for arbitration reviews and position for optimal success

- Provides monthly performance reporting to departmental leadership

- Confirms that all documentation adheres to company standards regarding privacy, compliance, legal aspects, and HIPAA standards

- Ensures all cases remain compliant with required timelines for responses and required company's input

- Performs other related responsibilities as assigned.

PROFESSIONAL EXPERIENCE:
- Three years or more experience in healthcare, health insurance, or healthcarecompliance
- At minimum, 1 year of claims processing experience
- Demonstrated success in arbitration, mediation, or contract negotiation setting
- Knowledge of the full Microsoft Office Suite of products to include, but not limited to, MS Outlook, MS Word, MS Excel, and MS PowerPoint

- Understanding of EOBs
- A background in healthcare collections, provider billing, negotiations or compliance is beneficial

EDUCATION:

- High School Diploma required
- 4-year college degree preferred but not required

Schedule: Monday - Thusday 8:30am - 5pm and Friday 8:30am - 3pm

Pay: $20-$25/hr DOE