Overview
This role provides specialized legal expertise to support healthcare providers in their revenue cycle management (RCM) processes. Responsibilities focus on developing compelling legal arguments, conducting legal and factual analyses, and using persuasive writing to help maximize reimbursement outcomes.
Responsibilities
- Analyze and dispute denied insurance claims for healthcare providers by drafting persuasive and effective administrative appeals
- Draft comprehensive appeal components addressing contractual, regulatory, and statutory issues
- Review contracts, provider agreements, and federal/state regulations to support denial resolution strategies
- Collaborate closely with analysts, clinicians, and operations specialists on complex cases
- Conduct targeted research to enhance appeal effectiveness and support business objectives
- Support systematic workflow improvements through specialized legal expertise
- Contribute to cross-service line legal analysis and trend identification
Requirements
- Juris Doctorate (J.D.) from an accredited institution
- Bar admission preferred but not required for strong candidates
- 0–2 years healthcare experience; revenue cycle management experience or exposure a plus
- Superior analytical and critical thinking capabilities
- Outstanding written communication skills with focus on persuasive argumentation
- Strong collaborative abilities and adaptability to team-based workflows
- Exceptional attention to detail and ability to work within established processes
- Commitment to healthcare privacy standards and operational protocols
- Interest in healthcare revenue cycle management and regulatory compliance, rather than traditional litigation
Preferred Qualifications
- Experience in contract analysis, appellate writing, or administrative law
- Familiarity with healthcare reimbursement concepts
Work at Home Requirements
- A quiet, distraction-free environment to work from in your home
- A secure home internet connection with speeds >20 Mbps for downloads and >10 Mbps for uploads is required
- The workspace area must accommodate all workstation equipment and related materials and provide adequate surface area to be productive
Location
Must reside in the United States within one of the states listed below:
- Alabama, Arkansas, Connecticut, Florida, Georgia, Iowa, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maine, Michigan, Minnesota, Missouri, Mississippi, North Carolina, Nebraska, New Hampshire, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota (CST Time Zone), Tennessee, Texas (CST Time Zone), Vermont, Virginia, Wisconsin, and West Virginia.
Employment Conditions
Employment is contingent upon eligibility to work in the United States, verification of employment history, and successful completion of a background check.
Equal Opportunity
The employer is an Affirmative Action/Equal Opportunity Employer committed to providing equal employment opportunities for all applicants and employees. Employment decisions are made without regard to any characteristic protected by applicable law, and individuals of all backgrounds are encouraged to apply.