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Role Description

This role supports ClearHealth Strategies’ Independent Dispute Resolution (IDR) team in a quasi-legal process focused on dispute review, eligibility analysis, and preparing arbitration briefs to ensure compliance with the federal No Surprises Act and state surprise billing laws.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to work an 8-hour shift schedule during our normal business hours of 8:00 am - 5:00 pm depending on the local time zone. It may be necessary, given the business need, to work occasional overtime.

• Prepare arbitration briefs.
• Respond to inquiries from CMS, arbiters, providers, clients, and ClearHealth management.
• Identify issues, analyze EOBs and claim information, apply critical thinking skills to formulate a plan of action, and resolve issues independently.
• Triage complex issues to management.
• Manage multiple priorities in a time-sensitive manner.
• Work in a fast-paced, high-volume environment with quick turnaround time.

Qualifications

• High School Diploma / GED OR equivalent work experience.
• Must be 18 years of age OR older.
• 1+ years of experience preparing written summaries, case reviews, reports, or briefs in a regulated, compliance-driven, or legal adjacent environment.
• 1+ years experience reviewing and interpreting claims data, Explanation Of Benefits, and supporting documentation to identify issues and determine appropriate next steps.
• Experience ensuring compliance with HIPAA privacy and security regulations.
• Work full-time between 8:00 am - 5:00 pm local time, including the flexibility to work occasional overtime given the business need.

Requirements

• 1+ years of experience working with the federal No Surprises Act (NSA) and/or state surprise billing disputes.
• Experience supporting or working within personal injury litigation.
• Knowledge of the medical claims process.

Telecommuting Requirements

• Ability to keep all company sensitive documents secure (if applicable).
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

Soft Skills

• Communicates clearly and professionally, with strong business writing skills.
• Effectively prioritizes tasks and manages workload to meet deadlines and goals.
• Works collaboratively and contributes positively to a team environment.
• Demonstrates a proactive, “ready to work, ready to learn” mindset.
• Upholds integrity, accountability, and strict confidentiality.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
• Hourly pay for this role will range from $23.89 - $42.69 per hour based on full-time employment.

Application Deadline

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.