Overview
This role provides counsel to the Subrogation Team and supports all aspects of the organization’s Subrogation operations.
Responsibilities
- Maintain current knowledge of relevant state and federal laws impacting healthcare subrogation, including Medicare and Medicaid; proactively monitor legislative and judicial developments.
- Build and maintain strong internal stakeholder and external client relationships.
- Evaluate, develop, and execute strategies for the successful litigation of subrogation claims.
- Conduct discovery and oversee outside counsel for subrogation litigation claims.
- Attend court hearings and mediations as necessary to advocate for clients’ positions on legal issues.
- Manage cases across the recovery process in accordance with client-specific procedures and guidelines.
- Maintain a calendar diary to monitor case activity and provide feedback to management and the unit on trends or developments.
- Negotiate settlements with third-party defendants, third-party insurance carriers, and attorneys.
- Identify and communicate risks proactively to internal and/or external stakeholders and recommend risk mitigation strategies.
- Provide counsel to the recovery team on complex subrogation legal issues.
- Coordinate recovery activities and provide legal research and counsel to recovery team members.
- Prepare and conduct training sessions for the subrogation departments as required.
- Draft and generate settlement documents needed to conclude payment on files and close them.
- Collaborate, coordinate, and communicate across disciplines and departments.
- Ensure compliance with HIPAA regulations and requirements.
Job Scope
- Works independently under minimal supervision and with considerable discretion to make decisions affecting Subrogation operations.
- Applies comprehensive knowledge of principles, practices, and procedures to complete job responsibilities.
- Acts as a resource for Subrogation Department staff.
- Uses sound logic to advance issues toward resolution when encountering ambiguity or uncertainty, select the best alternative considering pros, cons, tradeoffs, timing, and available resources, and make timely decisions requiring immediate attention.
- May have direct subordinates but will generally provide work direction to others who do not directly report to this job.
Requirements (Education, Experience, and Training)
- Law degree from an ABA accredited law school.
- Minimum five (5) years as an attorney and/or a minimum of three (3) years in medical claims, subrogation, and/or Medicare/Medicaid law as an attorney.
- Must be licensed to practice law; admission in multiple jurisdictions is preferable.
- Outstanding academic credentials, strong work ethic, and excellent verbal, writing, and research skills.
- Knowledge of legal elements of causes of action and theories of subrogation that form the bases of subrogation claims.
- Knowledge of statutes and case law governing issues specific to healthcare subrogation claims.
- Knowledge of procedural rules and common practices for discovery, settlement negotiations, hearings, and trials.
- Knowledge of legal research principles.
- Knowledge of computers and job-related software programs.
- Skill in negotiating with other attorneys, mediators, and adjusters.
- Skill in drafting court pleadings.
- Skill in analyzing and applying legal standards.
- Skill in delegation of responsibility and authority.
- Skill in decision making and problem solving.
- Skill in interpersonal relations and in dealing with the public.
- Oral and written communication skills, including excellent attention to detail and analytical skills.
- Effective communication skills (written, oral, and listening).
- Ability to orchestrate large volumes of data and meet critical deadlines.
- Strong internal and external client service skills.
- Highly motivated with a strong work ethic.
- Proficiency in MS Office applications.
- Ability to work independently and as an effective team member.
- Required licensures, professional certifications, and/or Board certifications as applicable.
- Ability to work in a standard office environment, including sitting and viewing monitor(s) for extended periods and operating standard office equipment such as, but not limited to, a keyboard, copier, and telephone.
Compensation & Benefits
- Salary range: $110k-$130k
- Offers may be based on a candidate’s education, experience, skills, work location, and internal equity.
- Eligible for health insurance, 401k, and bonus opportunity.
Equal Opportunity Employer
The organization is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law.
Additional Notes
Responsibilities outlined above are not necessarily all encompassing; other duties, responsibilities, and qualifications may be required and/or assigned as necessary.