Lien Resolution Strategist

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

📋 Description

• Manage a portfolio of Single Event medical lien files from the initial intake to final resolution.

• Establish negotiation strategies and settlement objectives, and assess when a review by leadership is necessary.

• Authorize settlement terms within designated authority limits.

• Review medical records, billing statements, insurance information, and plan documents to uncover opportunities for lien reductions.

• Negotiate lien reductions with healthcare providers, insurers, and government payers, addressing disputes, appeals, and requests for waivers or compromises.

• Engage directly with customers throughout the intake and resolution phases, providing guidance on lien strategies and the implications of settlements.

• Ensure quality and accuracy are maintained throughout the lifecycle of each file.

• Collaborate with Customer Success to nurture customer relationships and conduct regular check-in calls.

• Work in conjunction with Agency Management and medical review teams to establish and refine standards and workflows.

• Test research and development initiatives and new methodologies on live files and report outcomes.

• Delegate tasks related to files to support team members and coordinate their activities.

• Develop and enhance workflows for various medical lien types in collaboration with Product and Development teams.

• Experiment with negotiation strategies, sequencing, and documentation standards.

• Own and manage lien-resolution playbooks.

• Assist in setting productivity and capacity benchmarks.

• Provide practical feedback on portal functionalities and automated workflows.

• Apply federal and state lien regulations to complex case strategies.

• Maintain documentation that complies with internal standards and regulatory requirements.

• Stay updated on lien-resolution laws, regulations, and industry practices, sharing pertinent changes as necessary.

⛳️ Requirements

• Over 5 years of experience in medical lien resolution or subrogation, including direct negotiation of medical liens.

• Practical experience across various lien types, such as Medicare/MSP conditional payments, Medicaid, ERISA/self-funded plans, and hospital and provider liens.

• Familiarity with the Medicare Secondary Payer Act, ERISA plan language and preemption, as well as state lien statutes and reduction doctrines.

• Proven negotiation skills and experience in obtaining reductions from providers, insurers, and government payers, particularly for disputed or high-value liens.

• Experience in independently managing complex files that involve multiple liens, disputed amounts, appeals, and requests for waivers or compromises.

• Customer-oriented mindset with proactive, responsive, and dependable communication.

• Strong written and verbal communication skills, including the ability to advise attorneys on lien strategies and settlement results.

• Keen attention to detail in billing, records, and plan language.

• Experience in enhancing processes through procedures, playbooks, pilot programs, or system implementations.

• Ability to articulate reasoning clearly enough to document, teach, and incorporate into tools.

• Comfortable collaborating within a small, dynamic team with changing processes.

• Bachelor’s degree in a relevant field or equivalent professional experience.

• Must have authorization to work in the United States without the need for employer-sponsored visa support now or in the future.

🏝️ Benefits

• Private Health Care Plan (Medical, Dental & Vision).

• Company contributions to HSA for HDHP participants.

• Flexible Spending Accounts (Health & Dependent Care).

• Company-Paid Short-Term Disability Coverage.

• Optional Long-Term Disability, Life, AD&D, and Supplemental Coverage Options.

• 401(k) Plan with Company Match.

• Paid Time Off (Vacation, Sick Time & 10 paid Holidays).

• Parental Leave.

• Opportunity for quarterly discretionary bonuses.