Senior Insurance Attorney
4 days ago
About the Role:
We are seeking a highly skilled Senior Insurance Attorney to join our team at ICBD Holdings LLC. As a key member of our legal department, you will play a critical role in advocating for children with autism and developing policies and procedures that align with our company goals and philosophies.
Key Responsibilities:
- Collaborate with our Chief Legal Officer and other company attorneys to develop legal strategies that support our company values.
- Provide advice and guidance on revenue cycle management issues, particularly in regard to appealing wrongfully denied and delayed insurance claims.
- Advocate for children with Autism Spectrum Disorder (ASD) and oversee appeals relating to claims submitted to third-party payors.
- Draft appeals with insurance as part of the revenue cycle management process and review and negotiate single-case agreements with health insurance payors.
- Collaborate closely with admissions, utilization review, and clinical staff to develop, implement, and evaluate a legally compliant screening assessment and admissions process.
- Ensure compliance with state and accreditation agency requirements/guidelines and stay current with changes in state and federal laws and regulations regarding insurance/third-party payors and data privacy.
- Work within our proprietary technology framework to promptly update cases and streamline case management processes, supporting enhancements within the system and ensuring the accuracy of data.
Requirements:
- Juris Doctorate from an ABA-accredited institution.
- Licensed to practice in Florida or approved as Authorized House Counsel in Florida.
- Minimum 6-10 years of experience as a practicing lawyer, with an emphasis on health care/health insurance industry issues.
- Familiarity with medical and billing coding a plus.
- Large law firm experience preferred.
- Knowledge of behavioral health issues a plus.
- Knowledge of state and federal law regarding health care compliance, insurance regulations, and patient confidentiality laws.
- Knowledge of state guidelines and accreditation agency standards.
- Fluency in Spanish helpful.
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