IDR Arbitrator

About This Role

This role involves arbitrating and deciding payment disputes, analyzing documentation, and managing case files. It is for a highly skilled and detail-oriented arbiter with a strong understanding of Microsoft systems and excellent writing skills, working within a company focused on data-centric transformation in healthcare.

Responsibilities

• Arbitrate and decide payment disputes, and may also determine jurisdictional issues
• Review all dispute-relevant information; request additional information as authorized and required
• Decide whether the initiating party or non-initiating party will be awarded the arbitration decision
• Remain neutral when analyzing provided materials
• Write a concise determination in a short period of time to meet deadlines
• Review cases to determine and summarize facts and assess issues involved
• Collaborate with other technical and legal professionals, requesting and dispensing assistance as needed, verbally and in writing
• Research jurisdictional and substantive issues using federal and state law and regulations as they pertain to the No Surprises Act of 2020 and the Federal Independent Dispute Resolution Entity program
• Interpret applicable regulations and policies associated with the case to determine the appropriate decision, both concerning jurisdiction and the merits
• Communicate the determination in a clearly written format
• Exercise independent judgment to ensure determination is accurate, well-supported, and defensible; take appropriate action as required
• Draft and/or edit and review determination decisions
• Perform other duties as may be assigned by management

Requirements

• Juris Doctorate preferred
• Certified in Arbitration is preferred, required within the year
• Ability to perform comfortably in a fast-paced, deadline-oriented work environment
• Excellent organizational, interpersonal, written, and communication skills
• Ability to work as a team member, as well as independently
• Work across multiple systems, such as SharePoint, Salesforce, and Microsoft Office products

Important Details

• Schedule: may vary and may include weekend and holiday shifts

About the Company

Commence focuses on data-centric transformation to elevate health outcomes and power more efficient processes in program and patient health. The company combines data-driven solutions, advancing technology, and clinical expertise to create a more efficient path to quality care, with human-centered, healthcare-relevant, and value-based solutions.