Arbitration Specialist - Medellín, Colombia

On-site - Full Time

VIP Medical Group is a leading healthcare organization committed to providing high-quality, patient-centered care while building efficient and scalable healthcare operations. Our teams combine clinical expertise, technology, and strong operational processes to support patients and providers across the U.S. As we continue to grow, we are seeking a detail-oriented Healthcare IDR Case Specialist to help manage insurance disputes and Independent Dispute Resolution (IDR) cases from submission through resolution.

Position Summary:

​​​​​​​The Arbitration Specialist is responsible for managing U.S. healthcare insurance dispute and arbitration cases, ensuring each case is accurately documented, actively followed up, and progressed through every stage of the IDR process. This role requires strong attention to detail, ownership of deadlines, payer portal experience, and the ability to coordinate information across internal teams, insurance companies, and external partners. The specialist will research case details, prepare and submit documentation, monitor case status, resolve issues, and proactively identify anything that could delay resolution.

This is a hands-on operational role for someone who is highly organized, resourceful, and comfortable managing multiple cases simultaneously in a fast-changing healthcare environment.

What You'll Do:

IDR Case Management

- Manage assigned IDR and healthcare insurance dispute cases from initiation through resolution.

- Research case details and gather required information from internal teams, providers, insurance companies, and external partners.

- Prepare and submit complete and accurate documentation for Independent Dispute Resolution cases.

- Monitor case status, identify outstanding requirements, and ensure each case continues moving forward.

- Respond to requests, follow-ups, and additional documentation requirements throughout the arbitration process.

- Maintain accurate and up-to-date case records across designated systems.

Payer & Insurance Coordination

- Navigate payer portals and insurance websites, including platforms such as Availity, Optum, and Aetna, to research claims and case information.

- Navigate federal and state IDR platform portals to submit, monitor, and manage arbitration cases.

- Contact insurance companies by phone to verify claim status, gather information, resolve discrepancies, and obtain required updates.

- Research claims, EOBs, insurance requirements, and other documentation needed to support case resolution.





- Communicate professionally with insurance representatives and external partners by phone and email.

Documentation & Case Accuracy

- Review case documentation for completeness, accuracy, and consistency before submission.

- Identify missing information, discrepancies, and potential issues that could delay a case.

- Gather supporting documentation and coordinate with relevant teams to resolve information gaps.

- Maintain accurate records of case activity, submissions, communications, deadlines, and outcomes.

- Ensure case information remains current throughout the entire arbitration process.

Deadlines, Payments & Follow-Up

- Own case deadlines and proactively track upcoming submission, response, and resolution dates.

- Follow up on outstanding requests, unresolved issues, and delayed cases to prevent unnecessary delays.

- Process and monitor case-related payments, including arbitration fees, through resolution.

- Identify stalled cases and determine the appropriate next steps to move them forward.

- Escalate complex or time-sensitive issues when additional support is required.

Problem-Solving & Process Improvement

- Identify recurring obstacles, process gaps, and sources of delay across the IDR workflow.

- Take initiative to find solutions when standard processes do not resolve an issue.

- Recommend improvements to case management workflows, documentation, tracking, and follow-up procedures.

- Adapt quickly as healthcare regulations, payer requirements, and internal processes evolve.

- Contribute to the development of more efficient and scalable case management processes.

Team & Cross-Functional Collaboration

- Collaborate with internal healthcare, billing, administrative, and operational teams to gather information and resolve case requirements.

- Maintain clear and professional communication with internal and external stakeholders.

- Provide timely updates on case status, outstanding requirements, risks, and next steps.

- Work effectively within multicultural and international teams while maintaining accountability for assigned cases.

What You'll Bring To The Team:

- 1–2 years of experience in the U.S. healthcare or health insurance industry, preferably in medical billing, claims follow-up, accounts receivable, medical collections, insurance verification, or a related function.





- Advanced English proficiency; daily communication and case management will be conducted in English.

- Strong knowledge of U.S. healthcare insurance processes and terminology, including claims, EOBs, CPT codes, and in-network vs. out-of-network concepts.

- Hands-on experience navigating payer portals or insurance websites; experience with Availity, Optum, Aetna, or similar platforms is highly valued.

- Experience working with claims, insurance disputes, payment follow-up, or related healthcare administrative processes.

- Strong attention to detail and the ability to identify discrepancies or missing information.

- Excellent organization and time-management skills, with the ability to manage multiple cases, deadlines, and priorities simultaneously.

- Strong problem-solving skills and a proactive, resourceful approach to resolving issues.

- Confidence communicating with insurance companies, healthcare partners, and other third parties by phone and email.

- Ability to work independently while maintaining strong accountability for assigned cases.

- Strong interpersonal and professional communication skills.

- Proficiency with Google Workspace, including Gmail, Sheets, Docs, and Drive.

- Ability to adapt to changing processes, learn new systems, and work effectively in a fast-paced healthcare environment.

- Experience with IDR, arbitration, No Surprises Act processes, or out-of-network claims is a strong advantage.

We Offer You:

- Impactful Work: You'll play a crucial role in educating clients about their Insurance options and making a positive impact on their lives.

- Professional Growth and Learning: We're committed to your improvement and development. Join a team that values your potential and invests in your success.

- Supportive Environment: Work in a collaborative, supportive and comfortable environment where your ideas are valued, and your contributions are recognized.

- Adaptable Working Hours: Enjoy a comfortable 8-hour work shift from Monday to Friday for you to enjoy your weekends to the fullest!

- Competitive Compensation: Enjoy a competitive salary starting at $3.2M with benefits that reward your hard work and dedication.

​​​​​​​​​​​​​​​​​​​​​At RV Holdings S.A.S., we promote an inclusive, diverse, and respectful work environment. We value talent regardless of race, ethnicity, gender, sexual orientation, gender identity, age, beliefs, nationality, or disability status. All selection processes are conducted based on the competencies, skills, and experience of each individual

📌 Arbitration Specialist (Medellín)
🏢 Importante empresa
📍 Medellín