Complex Denials Consultant – Complex Claims

This is a fully remote position, open to applicants in United States.

📋 Description

• Supervise and assist in the recovery efforts for denied WC, MVA, Other TPL, and VA claims.

• Prepare intricate appeals, correspondence, and various documents as necessary.

• Comprehend and adeptly implement state-specific regulations pertaining to WC claims.

• Manage lien practices to ensure compliance with relevant state laws, Patient Protection Acts, and ongoing case law.

• Aid in the training of recovery staff members and offer essential feedback as required by management.

• Collaborate with external legal counsel on strategy, pleadings, settlement positions, and cost-benefit analyses.

• Create innovative legal and procedural arguments and tools for the team's utilization.

• Cultivate professional, collaborative relationships to promote favorable resolutions.

⛳️ Requirements

• Juris Doctor degree from an accredited institution.

• Admitted to the bar in one state or must be eligible for bar admission within six months of graduation.

• Legal experience focusing on one or more of the following areas: Healthcare law, Insurance defense or plaintiff personal injury, Hospital or health system legal affairs, Complex reimbursement or lien litigation.

• Proficient understanding of: MVA laws and insurance frameworks, Hospital lien statutes and their enforcement, Regulatory compliance in healthcare reimbursement.

🏝️ Benefits

• Competitive benefits package.