Attorney

Job Description

Job DescriptionPlease note this position can become Hybrid after the probationary period review.

Relocation bonus for qualified candidates upon approval.

COMPANY OVERVIEW:

Healthcare Legal Solutions, LLC is a fast-growing healthcare collections firm that provides denial management, consulting, and corporate collections services to hospitals and health systems nationwide. Our team is collaborative, mission-driven, and focused on results. This is a great opportunity for attorneys who are passionate about healthcare, legal writing, and strategy.

SUMMARY:

This position is responsible for settling a high volume of claims using creative, innovative, and flexible argumentation; managing an ample case load of corporate health claims; filing written appeals through administrative appeals processes to resolve problematic (e.g. underpaid or denied) medical claims for payment with governmental and corporate health payers.

DUTIES AND RESPONSIBILITIES:

• Quickly and efficiently review medical records and submit well-written compelling appeals to health insurers and governmental payers.
• Write demand letters and negotiate settlements from large corporate payers.
• Apply an expert understanding of Commercial, Governmental, Managed Care, and ERISA regulations regarding payment, coverage, conditions of participation, and other relevant topics to support appeal arguments.
• Assist legal appeals team in developing new and innovative legal and procedural arguments and tools.
• Oversee drafting of complex contractual appeals and administrative templates for organizational use.
• Guide legal interns and paralegals when needed.
• Perform administrative duties or projects as assigned by leadership.
• Navigate through various insurance systems and applications to find information about insurance claims.
• Follow all HIPAA guidelines and internal compliance protocols.

REQUIRED QUALIFICATIONS:

• Juris Doctoral Degree (J.D.) from an American Bar Association accredited law school.
• Licensed to practice law in at least one U.S. jurisdiction (DC, MD, VA, or PA preferred).
• Law school GPA of 3.0 or higher.
• 3+ years of legal experience, ideally in healthcare or administrative law.
• Proficiency in Microsoft Office, including Word and Excel, with the ability to quickly learn and operate new computer programs and software.
• Highly attentive to detail and able to handle large amounts of paperwork for a busy office.
• Clear, concise, and logical writing style.
• Excellent organizational and time management skills.

PREFERRED QUALIFICATIONS:

• Basic working knowledge of medical terminology and diagnostic procedures.
• Experience in healthcare claims, denial management, or reimbursement.
• Ability to work independently and efficiently with minimal supervision.
• Strong written and verbal communication.
• Dependability and sound judgement in time-sensitive matters.
• Team player with collaborative, feedback-oriented mindset.

COMPETENCIES:

• Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
• Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
• Attendance/Punctuality - Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan
• Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
• Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics
• Strategic Thinking - Develops strategies to achieve organizational goals; Understands organization's strengths & weaknesses; Analyzes market and competition; Identifies external threats and opportunities; Adapts strategy to changing conditions.
• Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.

BENEFITS:

• Competitive salary based on experience with opportunity for performance-based bonuses
• Health, dental, and vision insurance stipend - Choose your own plan (in process of conversion to group health so this is changing)
• 401(k) retirement plan with company contribution
• Vacation time, sick time, and paid holidays
• Professional development and training opportunities
• Subsidized Life and disability insurance
• Commuter benefits