Job Title

Join Our Team as a Senior Arbitration Administrator! We are seeking a detail-oriented and proactive individual to enhance our arbitration processes. As a Senior Arbitration Administrator, you will play a critical role in ensuring efficient case management and effective communication across various stakeholders. Key Responsibilities: Stay updated on corporate policies and procedures as outlined in the employee manual. Serve as a Subject Matter Expert in specific process areas. Analyze data submitted for Independent Medical Review to ensure accuracy and compliance. Collect and evaluate incoming data from healthcare providers, facilities, and participants to input necessary information into our systems. Respond to inquiries from clients, health plans, providers, and enrollees regarding case status and the appeals process. Establish and manage arbitration cases within our system. Request necessary information from healthcare providers and health plans to facilitate resolution. Efficiently close arbitration cases in the system after resolution. Conduct data analysis on information received from various healthcare entities. Minimum Qualifications: Associate degree with 2+ years of relevant experience; alternatively, a HS Diploma or GED with 4+ years of experience will also be considered. Strong organizational skills to manage multiple tasks efficiently while maintaining accurate records. Excellent verbal and written communication skills for effective interaction with healthcare professionals and insurance companies. Familiarity with multiple platforms and proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint) as well as healthcare billing systems. Adept at working in fast-paced, deadline-driven environments with high attention to detail in data entry and document management. Ability to work both independently and collaboratively in a remote team setting. Experience with Salesforce platform is a plus. Knowledge of healthcare billing, CPT codes, and regulations such as the No Surprises Act is preferred. Experience in healthcare appeals and grievances is advantageous. Familiarity with retroactive claim reviews and insurance documentation, including explanation of benefits and claim forms, is highly preferred. Availability to work Monday through Friday from 8:00 AM to 5:30 PM EST is required. Home Office Requirements: Minimum internet speed of 25 Mbps (50 Mbps for shared connections), with a minimum upload speed of 5 Mbps. Connection via Category 5 or 6 ethernet cable to your home router. Private workspace with adequate power source. Must reside permanently in the Continental U.S. Compensation: Salary range is $18.70 - $20.00 per hour, based on various factors including experience and qualifications. Equal Opportunity Employer: We embrace diversity and are committed to creating an inclusive environment for all employees. Accommodations: Maximus provides reasonable accommodations for applicants who need assistance during the employment process due to a disability or medical condition.