Overview
This role involves providing specialized legal expertise to support healthcare providers in their revenue cycle management (RCM) processes. The focus is on developing compelling legal arguments, performing analyses, and utilizing persuasive writing skills to maximize reimbursement outcomes for healthcare provider clients.
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 is 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 From Home Requirements
- A quiet, distraction-free environment to work from at home
- A secure home internet connection with speeds greater than 20 Mbps for downloads and greater than 10 Mbps for uploads
- Workspace area that accommodates all workstation equipment and related materials with adequate surface area to be productive
Compensation & Benefits
- Comprehensive medical, dental, vision, and life insurance benefits from the start of employment
- 12 paid holidays and flexible paid time off
- 401(k) contributions
- Employee Resource Groups that build community
- Career growth opportunities
- An excellent work/life balance
Location
- Remote position within the United States
- Candidates must reside in one of the following states: Alabama, Arkansas, Florida, Georgia, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Vermont, Virginia, West Virginia, or Wisconsin
Additional Information
Employment is contingent upon eligibility to work in the U.S., employment history verification, and a background check.
The employer is an equal opportunity organization that does not discriminate based on race, color, religion, sex or gender, gender identity or expression, sexual orientation, national origin, age, disability status, veteran status, genetic information, or any other legally protected status.