Team Lead, Arbitration Services

Team Lead, Arbitration Services

Claritev is a dynamic team of innovative professionals dedicated to bending the cost curve in healthcare. We are committed to service excellence for all stakeholders and foster a culture of boldness, innovation, accountability, diversity, and empowerment. Join us on our transformational journey to become a leading voice in healthcare technology, data, and innovation.

About the Role

The Arbitration Services Team Lead will oversee the daily activities of the Arbitration Services team, ensuring the team meets and maintains service, production, and quality standards. This role involves managing the team's workload, including the evaluation of provider disputes and client payment offers, while fostering team member growth and development. You will collaborate with team members and other leadership to achieve efficient and successful outcomes for arbitration matters.

Key Responsibilities

• Oversee the arbitration services team to ensure tasks are completed within required regulatory timeframes while maintaining production standards and quality assurance.
• Ensure all client deliverables and Service Level Agreements (SLAs) are achieved, providing exceptional results and root cause analysis for escalated client inquiries.
• Track trends, initiate process improvements to eliminate service delivery impediments, and ensure company and team goals are met.
• Ensure smooth and effective day-to-day team operations and consistently report results to the leadership team.
• Establish, maintain, and monitor individual and departmental performance expectations and metrics, implementing corrective measures for deficiencies and documenting employee progress.
• Assist in the development, implementation, and monitoring of department policies and procedures, and develop/implement system and operational changes to improve service and production efficiency.
• Assist with the creation, testing, and implementation of future automation and technical solution initiatives.
• Keep management informed of key operational, personnel, and client issues.
• Select, develop, and evaluate staff to ensure efficient department operation, implementing corrective action when necessary.
• Collaborate with other departments (Service Operations, QA, TG&D, Legal, Sales and Account Management, Data Science, HCE, and IT) to ensure successful product delivery.
• Respond promptly to all communications, log information, and maintain detailed and accurate records.
• Conduct outreach to clients for data needed for arbitration packages and attend client meetings as required.
• Maintain sensitivity to privacy in accordance with HIPAA guidelines.
• Ensure compliance with HIPAA regulations and requirements.
• Demonstrate Company's Core Competencies and values.

Job Scope

This role prioritizes the needs of external and internal customers in all decision-making. You will operate independently under limited supervision with decision-making authority within specified parameters, engaging your manager for proactive case resolution. You will work across customers, beneficiaries, providers, and supplemental payors, maintaining positive relationships. You will guide and coach team members, providing and prioritizing workload across the team.

Requirements

• Minimum high school diploma or equivalent (GED).
• Two (2) years of experience in healthcare operations. A Bachelor's degree in a related field is preferred.
• Minimum 1 year of management/leadership experience or 2 years in a senior role.
• Excellent organizational, analytical, and independent decision-making skills.
• Demonstrated critical thinking skills with the ability to manage multiple priorities and meet associated timelines.
• Ability to anticipate needs and solve problems proactively in a fast-paced, rapidly changing environment.
• Sound business judgment.
• Ability to learn quickly and work independently within time constraints.
• Proficient knowledge of Microsoft Word, Excel, and Outlook.
• Logical, clear, and concise written and verbal communication skills.

What We Offer

Claritev values its employees and offers competitive compensation and benefits packages, an incentive bonus program, and recognition and awards programs. We provide a friendly and supportive work environment with flexible schedules whenever possible. We also offer a wide range of professional development and educational programs to prepare you for advancement opportunities.

Your benefits will include:

• Medical, dental, and vision coverage with low deductibles and copays.
• Life insurance.
• Short-term and long-term disability.
• Paid Parental Leave.
• 401(k) with a company match.
• Employee Stock Purchase Plan.
• Generous Paid Time Off (accrued based on years of service).
• 10 paid company holidays.
• Tuition reimbursement.
• Flexible Spending Account.
• Employee Assistance Program.
• Sick time benefits (eligibility and accrual rates may vary by state law).

Claritev is an Equal Opportunity Employer.