Lien Resolution Team Lead

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

📋 Description

• Oversee, mentor, and assess a team of specialists in reductions and lien resolution.

• Allocate files, manage workload distribution, conduct regular file evaluations, and enhance team negotiation capabilities.

• Monitor and report on overall reduction percentages, savings achieved, aging data, and turnaround time from settlement to disbursement.

• Identify missed savings opportunities and enact improvements.

• Personally handle negotiations for high-balance, complex, and escalated reductions.

• Address Medicare conditional payments and obligations under the Medicare Secondary Payer framework.

• Lead the resolution of Florida Medicaid (AHCA) claims, including navigating the administrative challenge process.

• Resolve claims related to ERISA and self-funded plans, TRICARE and VA claims, as well as hospital and provider liens.

• Negotiate balances related to letters of protection and maintain necessary documentation.

• Evaluate health insurance payments, PIP benefits, and other collateral sources to determine reimbursement exposure.

• Foster relationships and establish standing reduction agreements with providers, facilities, and lien resolution vendors.

• Supply attorneys with precise lien exposure figures for settlement authority and client net-recovery decisions.

• Ensure clients are well-informed about closing statements, guaranteeing that disbursements are accurate, documented, and timely.

• Standardize templates, escalation procedures, and negotiation playbooks.

• Recommend and assist in implementing improvements to case management systems and workflows.

• Ensure adherence to trust accounting, Florida Bar, and firm documentation standards prior to fund release.

⛳️ Requirements

• At least four (4) years of experience in medical lien resolution, reductions, or settlement negotiation within a personal injury firm, lien resolution company, or healthcare recovery vendor.

• Experience managing a minimum of 5 people in previous roles (direct or indirect reports).

• Proven history of negotiating significant reductions on medical balances and liens, supported by relevant metrics.

• Familiarity with Medicare Secondary Payer regulations and conditional payment resolutions.

• Understanding of Florida Medicaid third-party recovery and the AHCA lien process.

• Knowledge of ERISA plan reimbursement claims and the distinctions between self-funded and fully insured plans.

• Comprehension of Florida PIP and the collateral source framework as it relates to reimbursement exposure.

• Strong grasp of settlement mathematics, including gross to net calculations, attorney fees and costs, pro rata allocations, common fund principles, and made-whole considerations.

• Excellent communication skills, both written and verbal.

• Proficiency in legal case management software and spreadsheet applications.

• Bilingual in English and Spanish, both spoken and written (preferred).

• Experience in a high-volume Florida plaintiff personal injury firm (preferred).

• Background in negotiating with hospital systems and large provider groups in the South Florida market (preferred).

• Possession of a paralegal certificate or a bachelor's degree in a related field (preferred).

• Experience in developing or refining a reductions workflow from the ground up (preferred).

• Familiarity with Medicare Set-Aside considerations in third-party liability settlements (preferred).

🏝️ Benefits

• Work remotely five days a week.

• Opportunity to advance a litigation career.

• Engaging, innovative, and high-accountability work culture.

• Opportunities for professional growth and leadership development.