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 hi

Team Lead, Arbitration Services at Claritev