Staff Attorney

1 week ago

Nashville, Tennessee, United States CultivaHR Full time
Job Description

Ternium is a leading provider of premium, professional revenue cycle management services which resolves challenging healthcare insurance claim denials and delays to positive resolution for our partners. Our mission is to be the trusted partner of health systems and hospitals in their most challenging and complex areas of revenue cycle, so that they may focus on what matters most, patient care. With our professional and experienced staff, we are able to scale our operating model to meet our partner's needs, quickly driving superior results in net patient revenue and cash flows, while reducing operating costs and improving the patient experience.

Key Responsibilities

  • Represent healthcare providers in denied claim disputes, primarily shepherding disputes through an administrative appeals process (no litigation involved).
  • Develop innovative and novel legal and procedural arguments to effectuate positive resolution of denial medical claims.
  • Draft complex and persuasive appeal letters to insurance organizations and benefit administrators.
  • Leverage payor provider manuals and managed care contracts to successfully resolve denied medical claims.
  • Work directly with provider representatives and enhanced resolution units to successfully resolve complex issues.
  • Provide education, payor trends, denial trends, and training of recovery staff team members at partner provider organizations.
  • Conduct legal research and analysis to support business model.


Requirements
  • Juris Doctor 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
  • Remote
  • Starting salary $55,000-$65,000 per year (commiserate with experience)
  • 401(k) with corporate match
  • Dental insurance
  • Employee assistance program
  • Flexible schedule
  • Health insurance
  • Vision insurance
  • Life insurance
  • Paid time off
  • Bar Due reimbursement
  • Bonus opportunities
  • The opportunity to grow personally and professionally with a dedicated and supportive team experiencing a tremendous growth

Ternium is dedicated to the fundamentals of equal employment opportunity. The Ternium's employment practices, including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, Ternium is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

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