MET Healthcare Solutions is a healthcare management group headquartered just north of the Heights in Houston, Texas.
At MET Healthcare Solutions, our goal is to provide the highest quality services by combining industry best practices with the industry’s best staff. Come join our team as a Medical Dispute Resolution Quality Analyst to begin making a difference in the healthcare industry.
The Medical Dispute Resolution Quality Analyst is responsible for auditing independent dispute resolution (IDR) determinations to ensure compliance with the metrics and criteria surrounding the IDR process.
As a Medical Dispute Resolution Quality Analyst, you will work with internal teams of attorneys, medical coders, and other dispute resolution auditors to monitor and review arbitrator determinations that will directly improve the healthcare industry.
The ideal Medical Dispute Resolution Quality Analyst candidate will have a well-rounded knowledge of insurance payers, arbitration/litigation processes, and excellent interpersonal communication skills.
Key Responsibilities Include (but are not limited to):
· Maintain a thorough understanding of the dispute resolution process, current regulations, and updates to regulations.
· Conduct continuous analysis/audits of the arbitrators’ findings to ensure compliance with the industry’s regulations.
· Ability to ensure timely completion of all components of the audit.
· Track trend data over time to determine if performance standards are being met.
· Track and respond to requests from arbitrators by submitting all supporting documentation to assigned arbitrators.
· Submit arbitrators’ final determinations through the appropriate computer systems.
· Ability to meet deliverables, quality assurance and methodology standards.
Knowledge, Skills, and Abilities:
· Robust knowledge of dispute resolution/arbitration processes.
· Above average verbal and written communication skills.
· Familiar with emergency room and hospital coding and billing processes.
· Paralegal experience or medical coding experience is preferred.
The Medical Dispute Resolution Quality Analyst position is offered as a hybrid position and requires your presence in the office 2-3 times per week.
Job Type: Full-time
Pay: $21.00 - $23.00 per hour
Expected hours: 40 per week
Benefits:
- Health insurance
- Paid time off
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
Education:
Experience:
- Paralegal: 2 years (Preferred)
Shift availability:
Ability to Commute:
- Houston, TX 77018 (Required)
Ability to Relocate:
- Houston, TX 77018: Relocate before starting work (Required)
Work Location: Hybrid remote in Houston, TX 77018