Support remote supervision governance, produce remote supervision packs, and coordinate MI. Run data quality checks, lead incorporation of new metrics, and collaborate with IT teams to automate MI. Implement control frameworks, perform gap analyses, and drive risk remediation activities. Monitor trade bookings for EEA clients and investigate potential breaches.
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The Arbitration Specialist III is responsible for the day-to-day submission of out-of-network disputes utilizing the dispute resolution process utilizing the State or Federal independent dispute resolutions processes, known as “arbitration”. The role involves monitoring deadlines, managing dispute inventory, and supporting the negotiation and filing processes, requiring advanced skills in computer applications and knowledge of healthcare billing.