Quality Assurance Arbitration Specialist II - Shared Services

HaloMD

Who We Are: 

We are a fast-growing arbitration/medical billing company looking for a positive person who is interested in being a success and will help take the company to the next level. The seasoned professional for this job needs superior communication and computer skills including familiarity, with Microsoft Outlook, Word and Excel.  This individual specializes in the resolution of arbitration negotiations, schedule arbitration teleconferences, and performs a wide variety of tasks such as generating reports, correspondence, and setting up informal offers.

Job Summary

The Quality Assurance Arbitration Specialist II will coordinate the staff’s daily operations with a focus on ensuring high-quality work and compliance with established standards. This role has overall responsibility for training and developing the skills of new quality assurance team members, conducting regular audits, identifying process gaps, and recommending improvements. The Specialist II will maintain and update all QA forms, newsletters, and training guides to support ongoing quality initiatives.

Essential Job Duties and Responsibilities

• Train new QA team members on quality assurance forms, workflows, and best practices.
• Monitor all quality assurance forms, audit completed work for accuracy, and update auditing templates as needed.
• Conduct regular quality reviews to ensure compliance with company policies, arbitration procedures, and industry regulations.
• Develop and distribute monthly newsletters with tips, updates, and quality improvement strategies for team members.
• Utilize Microsoft Office (especially Excel) to create performance tracking tools, including formulas, pivot tables, and filters for data analysis.
• Assist in identifying trends by Arbitrator/Health Plan and report recurring issues.
• Identify system errors and coordinate with appropriate departments for resolution.
• Organize QA findings into concise, actionable reports for leadership review.
• Re-prioritize key tasks as needed and meet regularly with upper management to present findings, trends, and improvement plans.
• Maintain documentation of audit results, corrective actions, and follow-up to ensure improvement.
• Provide clear, constructive feedback to team members to help them meet quality and productivity goals.
• Develop training guides and process documentation to ensure consistent quality standards.
• Strong understanding of insurance plans, medical billing processes, and policies.
• Demonstrate professionalism and confidentiality in all internal and external interactions.
• Apply analytical and problem-solving skills to identify root causes of quality issues and recommend preventive measures.
• Complete special projects and other duties as assigned.
  
  

Education and/or Experience

• High School Diploma or equivalent required
• Minimum of 2 years Revenue Cycle Management Experience
• IDR experience (preferred)
• Leadership experience (preferred)

Skills/Specialized Knowledge

• Strong organizational analytical and problem-solving skills
• Knowledge of insurance industry
• Knowledge of independent dispute resolution process
• Ability to clearly communicate both verbally and in writing
• Knowledge of medical terminology
• Knowledge of CPT, and/or ICD-10
• Friendly, outgoing personality
• Basic knowledge of company policies and procedure
• Knowledge of legal and regulatory government provisions
• Knowledge of laws that regulates communication and privacy act. HIPAA laws and understanding of the application of all above
• Experience with MS Office applications including Word, Excel, Access, Outlook, PowerBI

Other Requirements

• Must maintain professional appearance
• Ability to be at work at regular and consistent times

Perks & Benefits:

• Fully Remote – Work from anywhere within the United States with reliable high-speed internet
• Multiple medical plan options
• Health Savings Account with company contributions
• Dental & vision coverage for you and your dependents
• 401k with Company match
• Vacation, sick time & Company paid holidays
• Company wellbeing program with health insurance incentives

What’s Next?

If you’re ready to bring your skills, passion, and leadership to our growing team, we want to hear from you! Apply today and help us create a future where success is the standard. 

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