Payment and Arbitration Support Specialist in Clifton, New Jersey at Progressive Spine and Orthopaedics LLC

JOB TITLE: Payment and Arbitration Support Specialist
COMPANY: Progressive Billing
PAY RANGE: OPM Pay Grade 6 (Hourly)
FLSA Status: Non-Exempt

SUMMARY: The Payment and Arbitration Support Specialist is responsible for accurate posting, reconciliation, and tracking of insurance-related payments primarily check payments and settlements- while supporting arbitration case preparation and status tracking. This role ensures clean financial records, timely documentation in ModMed and other systems, and dependable communication across internal teams and legal partners.

ESSENTIAL DUTIES AND RESPONSIBILITIES:
Payment Processing and Check Management
Post and reconcile PSO insurance live checks and settlement checks.
Post and reconcile older PSC payments, ensuring accurate historical cleanup and documentation.
Manage and support EMGs and OV appeals related to PIP carriers, including payment
identification and follow-through.
Scan all PSO/PSC checks and accurately apply payments within the system.
Identify potential underpayments; adjust paid-in-full accounts when needed and set funds aside for arbitration review when appropriate.
Post check payments into Micro.
Prepare and submit a daily check deposit summary.
Update all related financial and tracking spreadsheets daily, including:
o General check payment tracking spreadsheets
o Pay-to-Member spreadsheet (including allocation of check payments received from other offices)

Arbitration Support:
Prepare arbitration (arb) case packets and supporting documentation, specifically to support Marketing and Business Development’s efforts and assist with attorney relationship development.
Track arbitration cases to ensure visibility on which attorney is assigned to each matter and where the case stands in the process.

Documentation and System Updates:
Maintain clear, consistent documentation of payment and arbitration activities within ModMed, ensuring traceable, audit-friendly records.
Complete timely case updates and status changes in ModMed to support internal tracking and legal coordination.

Internal Communication and Team Support:
Serve as a go-to resource for updated check statuses and questions related to payment posting or arbitration cases.
Collaborate across departments to support reconciliation efforts and resolve check status discrepancies.

Qualifications:
Education & Experience:
High school diploma or equivalent required.
Minimum of 3–5 years of medical billing experience, with a strong focus on arbitration and posting

Knowledge & Skills:
Strong attention to detain and accuracy in posting and reconciliation work.
Comfort working in fast-paced environments with daily deadlines (deposits, posting, spreadsheet updates)
Experience with EHR/practice systems (especially ModMed) and payment posting workflows preferred
Proficiency with spreadsheets (Excel/Google Sheets): tracking, reconciliation, and data accuracy
Professional communication skills for coordinating with internal teams and legal/attorney partners.
Ability to manage multiple priorities while maintaining complete documentation.

Work Environment & Physical Requirements
Office-based role with prolonged periods of sitting and computer use.
Standard business equipment required.
Overtime may be required based on workload and business needs and will be compensated in accordance with non-exempt wage and hour requirements.

Performance Expectations:
Payments posted and reconciled accurately with minimal rework.
Daily deposit summaries completed consistently and on time.
Spreadsheets updated daily with clean, reliable data.
Arbitration packets prepared accurately and delivered on schedule.
ModMed documentation and case statuses consistently current and traceable.

DOL / FLSA Classification Justification
Based on the duties and responsibilities described, the Payment and Arbitration Support Specialist position is properly classified as nonexempt under the Fair Labor Standards Act. The role primarily involves clerical and technical tasks such as posting and reconciling payments, managing check processing, maintaining spreadsheets, preparing arbitration packets, updating systems, and tracking case statuses. These responsibilities are performed by following established procedures and organizational requirements and do not involve policy making, advanced specialized professional knowledge, or management of employees. The position does not exercise the level of independent judgment and discretion required for the administrative, executive, or professional exemptions, nor is it paid on a salary basis tied to exempt duties. Because the primary functions are transactional, production focused, and support oriented, employees in this role are entitled to overtime pay for all hours worked over forty in a workweek in accordance with federal and applicable state wage and hour laws.