Overview
This role leads the lien negotiation function for the organization. You will own the end-to-end process of identifying, validating, negotiating, and resolving medical liens and subrogation claims so clients receive the maximum net recovery on their settlements.
You will also lead a team of lien negotiators, set strategy for high-value and complex liens, and partner with attorneys, case managers, and finance to ensure timely, compliant disbursements.
Responsibilities
Negotiation and Strategy
- Negotiate reductions on medical provider liens, letters of protection, hospital liens, health insurer and ERISA plan reimbursement claims, Medicare, Medicaid, and other subrogation liens (including MedPay).
- Negotiate reductions on any pre-settlement funding loans.
- Develop and refine reduction strategies based on lien type, governing law, case value, policy limits, and procurement-cost principles.
- Obtain final amounts on general liens, such as child support liens.
- Personally handle high-dollar, contested, or escalated lien matters.
- Partner with attorneys to factor lien exposure into settlement evaluation, demand, and mediation strategy.
Team Leadership
- Hire, train, manage, and mentor lien negotiators and support staff.
- Set performance goals and track metrics, including average reduction percentage, total client savings, cycle time, and open lien inventory.
- Build standardized workflows, scripts, templates, and escalation protocols.
Process and Compliance
- Oversee lien identification and verification, including itemized bills, lien notices, ERISA plan documents, and conditional payment letters.
- Proactively flag and obtain potential missing liens.
- Ensure compliance with Medicare Secondary Payer rules, Medicaid recovery statutes, state hospital lien laws, and applicable ethics and trust accounting requirements.
- Work with the finance team to ensure accurate settlement statements, lien holds, and timely disbursement.
- Maintain documentation of all negotiations, agreements, and final payoff confirmations.
Relationships and Reporting
- Build and maintain relationships with medical providers, lien-purchasing companies, health plans, third-party recovery vendors, and government agencies.
- Evaluate and manage outside lien resolution vendors, if applicable.
- Report regularly to firm leadership on department performance, trends, and risk.
Systems and Reporting
- Maintain lien data in the firm’s case management system and drive adoption of best practices.
- Identify opportunities for automation and process improvement.
Requirements
- 7+ years of experience in lien resolution, subrogation, or settlement negotiation, preferably in a personal injury or plaintiff-side environment.
- 3+ years of experience managing or leading a team.
- Demonstrated record of securing significant lien reductions across multiple lien types.
- Working knowledge of Medicare/Medicaid recovery, ERISA (self-funded vs. fully insured plans), and state lien and made-whole/common-fund doctrines.
- Strong negotiation, analytical, and communication skills.
- Proficiency with case management software and Excel or comparable reporting tools.
Preferred Qualifications
- JD, paralegal certification, or equivalent legal training.
- Experience in a high-volume PI firm or lien resolution company.
- Familiarity with medical billing, CPT/ICD coding, PIP statutes, and reasonable-value analysis.
- Experience building or scaling a lien department.
Compensation & Benefits
Compensation
- Compensation Range: $129K - $152.5K
Benefits & Perks (Full-time)
- Choice of medical, dental, and vision insurance plans for you and your family.
- Additional insurance coverage options for life, accident, or critical illness.
- Flexible paid time off, sick leave, short-term and long-term disability.
- 10 US observed holidays, and Canadian statutory holidays by province.
- Home office stipend.
- 401(k) for US-based employees and RRSP for Canada-based employees.
- Paid parental leave.
- A local in-person meet-up program.
- Hubs in San Francisco and Toronto.
Location
Hubs in San Francisco and Toronto.
Equal Opportunity & Candidate Notice
- The organization is an equal opportunity employer.
- The organization does not accept resumes or expressions of interest via email or social media messages; applications must be submitted directly through the careers page.
- The organization may use AI notetakers and other recording devices in the recruiting process. If you interview, with your consent, conversations may be recorded and summarized into notes for internal use. Recording is optional, and declining will not affect candidacy.