Claims Resolution Coordinator

Job description:

Overview

Advanced Reconstructive Surgery Alliance (ARSA) and its affiliates are the largest Plastic Surgery medical practice in the country. Our expanding team of top tier physicians, coupled with our continued medical advancements, allows us to offer patients extraordinary clinical services with 5-star experience. We have a bold vision with a desire to revolutionize the industry; meeting patient needs while favorably transforming their lives. Common across the enterprise is not only the commitment to providing safe patient care, but to employee satisfaction and growth opportunities. It is a culture of teamwork, respect and appreciation for all employees—whether caring for patients directly or working in a support role.

We are seeking a Claims Resolution Coordinator.

The Claims Resolution Coordinator manages and resolves complex medical claim disputes and appeals, focusing on compliance with the Federal No Surprises Act (NSA) and related state billing laws. This role requires strong analytical skills, attention to detail, and the ability to evaluate claims, prepare persuasive arguments, and navigate dispute and arbitration processes efficiently.

Key Responsibilities

• Review and analyze medical claims to ensure accuracy, compliance, and eligibility for dispute or appeal under the NSA and state regulations.
• Investigate claim denials by reviewing documentation, contracts, and billing details.
• Initiate and manage disputes under the NSA framework, preparing clear and evidence-based arguments.
• Submit offers and position statements during arbitration or negotiation processes.
• Collaborate with legal, billing, and compliance teams to ensure timely and compliant case resolution.
• Analyze dispute data to identify trends and opportunities for process improvement.

Skills and Qualifications

• Bachelor’s degree in Business, Healthcare Administration, or related field preferred.
• 1–3 years in healthcare claims processing required
• Experience with No Surprises Act dispute resolution highly preferred.

Skills:

• Strong analytical and problem-solving abilities.
• Excellent written communication and organizational skills.
• Proficiency in Microsoft Office and practice management systems (e.g., Practice Plus).
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.

Compensation & Benefits:

• Pay Range: $55,000-$60,000 annually

the starting rate within this range for this role varies depending on a number of factors, including a candidate’s qualifications, skills, competencies, experience, and location.

• Medical, Dental, Vision, Life, HSA and Long-Term Disability insurance
• 401k and Profit sharing
• Paid Time Off
• Mileage Reimbursement
• Contribution to Health Benefits
• Company Discounts on Products & Services