Senior Legal Advocate for Healthcare Providers

3 weeks ago


Detroit, Michigan, United States CultivaHR Full time
Job Summary

This is a unique opportunity to leverage your legal expertise in a non-traditional role. As a Senior Legal Advocate, you will represent healthcare providers in disputes with medical insurance carriers and managed care organizations. Your analytical skills and knowledge of commercial and managed care insurance claims policies and procedures will enable you to develop innovative arguments and successfully resolve denied medical claims.

Main Responsibilities
  • You will shepherd disputes through an administrative appeals process, working closely with provider representatives and enhanced resolution units.
  • Develop complex and persuasive appeal letters to insurance organizations and benefit administrators.
  • Leverage payor provider manuals and managed care contracts to effectuate positive resolutions.
  • Conduct legal research and analysis to support business models.
  • Provide education on payor trends, denial trends, and training of recovery staff team members at partner provider organizations.

Requirements
  • Juris Doctor degree required.
  • State Bar Membership preferred.
  • Strong analytical and problem-solving skills.
  • Excellent written and verbal communication skills.
  • Ability to work independently and as part of a team.
  • Attention to detail and the ability to prioritize within a dynamic environment.
  • Ability to adhere to all HIPAA and company policies and regulations.

Benefits
  • Full-time position.
  • Remote work available.
  • Starting salary $55,000-$65,000 per year (commensurate with experience).
  • 401(k) plan with corporate match.
  • Dental insurance.
  • Employee assistance program.
  • Flexible schedule.
  • Health insurance.
  • Vision insurance.
  • Life insurance.
  • Paid time off.
  • Bar Due reimbursement.
  • Bonus opportunities.

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