Job Description

Job Description

Job Description

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.

POSITION SUMMARY:

Ideal candidates will be able to settle a high volume of claims using creative, innovative, and flexible argumentation. We will provide intensive training in writing, legal argumentation, and medical record analysis. From there, thinking outside the box is a must.

Candidates will manage an ample case load of corporate health claims. This involves 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. In this role, you will have the opportunity to work alongside a dynamic team and great clients. We have part-time to full time positions available. The position would be hybrid with the possibility for fully remote work based on performance. This is an hourly part-time position, for 20 hours/week or more depending on performance.

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 with development of legal tools, contract-based arguments, and templates for legal appeals.
• 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.
• Navigate through unfamiliar jurisdictions and processes in order to appeal and settle claims.
• Follow all HIPAA guidelines and internal compliance protocols.

REQUIRED QUALIFICATIONS:

• J.D. from an ABA-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 Word, Excel, and comfort with learning new software.
• Highly attentive to detail and able to handle large amounts of paperwork.
• Clear, concise, and logical writing style.
• Excellent organization, and time management skills.

PREFERRED QUALIFICATIONS:

• This position is particularly well-suited for experienced or retired attorneys seeking a flexible, part-time schedule.
• Basic working knowledge of medical terminology and diagnostic procedures.
• Experience in healthcare claims, denial management, or reimbursement.
• Ability to work independently with minimal supervision.
• Strong written and verbal communication.
• Dependability and sound judgement in time-sensitive matters.
• Team player with a 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.

Starting at $50/hour depending on experience and credentials.

Interested candidates should submit a resume with their law school GPAs. Applications without GPAs will not be considered.

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