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Years of Experience
Attorney Responsibilities : The candidate will solve issues presented by employers, the health plans, and those that service them; such as responding to audits, ensuring regulatory compliance, explaining plan terms, applicable laws, and resolving disputes between health plans, patients, and healthcare service providers – in an effort to protect plan members and sponsors. Duties will include conducting legal research, responding to questions regarding agency rules, statutory requirements, and legal compliance, communicating with plan administrators, and answering any number of questions regarding administration of compliant health plans in light of applicable rules and laws.
Qualification and Experience
Requirements : The candidate should have a Degree from an accredited law school and admittance to a State Bar. 3-5 years experience relating to: Health benefit plan administration; Hospital billing and payment rules and processes; Healthcare and ERISA law; Experience with healthcare regulatory / agency law, including IRS, DOL, and HH. Knowledge of latest developments in healthcare, the Patient Protection and Affordable Care Act, and ERISA. Must show demonstrable experience with, or interest (study) in, regulatory and agency law, including IRS, DOL, and HHS, especially as it relates to employee benefit plans. Excellent attention to detail with the ability to multi-task. Excellent analytical skills. Ability to scan relevant materials quickly and accurately. Ability to effectively communicate and interact with varied positions throughout the organization as well as clients. High level of proficiency using Microsoft Word, Excel and Microsoft Outlook required. Outstanding organizational, interpersonal and negotiation skills. Excellent telephone, writing and proofreading skills. Must be self-motivated and able to meet deadlines under pressure. Must have the ability to work as part of a team, as well as to work independently. Proven record in managing cases involving Medicare and CMS, billing and payment rules and processes. Past work within or related to the healthcare and insurance industries.
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