Team Lead (State Operations) - MPOWERHealth

HaloMD

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.

Benefits:

• 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

Job Summary

The Team Lead of Arbitration will supervise and coordinate the staff’s daily operations. This role will have the overall responsibility for mentoring and developing skills of direct reports. The Team Lead will participate in evaluation and implementing quality control and performance improvement activities.

Essential Job Duties and Responsibilities

• Analyze workflow reports to determine cases eligible for IDR Process
• Assist with identification of trends by Arbitrator/Health Plan
• Identify system errors
• Develops and organizes reports into a format that can easily be evaluated by Leadership
• Have the ability for re-prioritizing key tasks and meet with upper management to provide updates of findings and outcomes
• Work with external vendors such as State Department of Insurance (DOI) personnel and arbitrators to assist with issues and resolutions
• Complete special projects and other duties as assigned

• Strong organizational, analytical, and problem-solving skills
• Knowledge of the insurance industry
• Professionalism in all dealings, both internal and external customers
• Ability to clearly communicate, both verbally and in writing
• Strong understanding of insurance plans and policies
• Ability to motivate and train employees
• Proven ability to maintain high productivity standards
• Develop a strategy that the team members can use to better reach a project goal
• Assign tasks to team members
• Ability to keep team within KPI standard or find improvement to surpass improvements
• Determine the completion timeline and monitor progress to keep the project on track and on schedule
• Communicate clear instruction to team members
• Manage the flow of day-to-day operation
• Knowledge of medical terminology
• Other duties as assigned

Education and/or Experience

• High School degree 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

Physical and Mental Demands

This position will spend long hours sitting and using office equipment and computers. The position may also entail light lifting of supplies and materials occasionally, up to and including 20 pounds in addition to reaching, stooping, standing, and walking. This position requires the ability to talk, hear, compare, compute, compile, copy, analyze, coordinate, synthesize, negotiate and communicate. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.

Work Environment

Remote work environment, ability to work independently and in a group environment

It is the policy of HaloMD not to discriminate against any applicant for employment, or any employee because of age, color, sex, disability, national origin, race, religion, or veteran status.

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