Legal Negotiator

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

📋 Description

• Assist the Legal Department by overseeing claim negotiations, appeals, and associated legal documentation.

• Examine claim details, supporting documents, and system data to assess settlement strategies.

• Draft, present, and negotiate settlement proposals with clients, providers, and third-party collection agencies.

• Handle appeals until resolution while complying with internal policies and relevant regulations.

• Address complex or escalated claims and pinpoint issues that require further legal examination.

• Ensure accurate and timely record-keeping of negotiations, communications, and results.

• Monitor claim statuses, deadlines, and resolution metrics within internal systems.

• Liaise with internal departments and external parties regarding claim progress, settlement proposals, and timelines.

• Provide follow-ups and clarifications throughout the negotiation process.

• Align negotiation tactics and resolutions with contractual commitments, laws, and regulations.

• Identify trends in claims, recurring issues, and potential risks; report concerns to Legal leadership.

• Collaborate with Legal, Operations, Client Services, and other internal teams.

• Contribute to templates, procedures, and best practices pertaining to claims negotiations and appeals.

⛳️ Requirements

• A Bachelor’s degree is mandatory.

• Preferably two to five (2–5) years of experience in legal, paralegal, claims, or healthcare-related positions.

• Strong preference for experience in settlement negotiations, claims resolution, or appeals.

• Preferred experience in applying ERISA and ACA requirements during claim reviews, appeals management, and settlement negotiations.

• Familiarity with the No Surprises Act, including negotiation and IDR process requirements, is preferred.

• Strong skills in negotiation, problem-solving, and conflict resolution.

• Exceptional interpersonal and customer service abilities.

• Clear and professional written and verbal communication skills.

• Excellent organizational abilities with a keen attention to detail.

• Effective time management skills with the capacity to prioritize competing deadlines.

• Ability to analyze complex claim data and accurately apply plan language.

• Proficient in claim documentation systems.

• Capability to work independently within a collaborative, team-oriented environment.

• Typing speed of at least 60 words per minute.

• Proven discretion and ability to manage confidential information.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health and wellness benefits.

• Opportunities for professional development and growth.

• Flexible work arrangements and a supportive team environment.