Job Details

Health Care Attorney in Washington, DC

Organization Type

In-House

Job Type

Attorney

Posted on

May 04, 2021

Years of Experience

Min 5 yrs required

Location

Washington, DC, United States
Practice Area
Health Care >> Health Care
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Healthcare Attorney
The candidate will be responsible for working with clients (e.g., group health plans, ERISA fiduciaries, other medical cost payors, etc.) to develop and implement medical payment integrity policies and programs aimed at reducing the level of overpayments made by the client due to medical billing errors and related issues. Will also manage and work with a team of highly skilled paraprofessionals in the negotiation, settlement, and collection of overpayments that have been made by the client. Work with clients’ medical payment integrity personnel to develop/implement payment policies and programs aimed at reducing medical spending. Communicate and negotiate with medical facilities regarding medical bills and related charges. Manage a highly skilled team of paraprofessionals in the negotiation, settlement, and collection of medical bill overpayments that have been made by the client. Stay up to date with caselaw as well as changes to legislation, regulations, and sub-regulatory guidance applicable to area of practice.

Qualification and Experience

The candidate must have Bachelor’s degree. Juris Doctor (JD) degree required and license to practice law in DC and/or VA essential. Must have 5+ years of relevant experience in a law firm or in-house contracting department. Should possess high level understanding of Commercial, Governmental, Managed Care, and ERISA regulations regarding payment, coverage, conditions of participation, and other relevant topics related to group health plans. Familiarity with stop-loss needed. Knowledge and experience with CMS reimbursement guidelines essential. Must possess knowledge of hospital claims billing and coding rules and guidance. Familiarity with revenue cycle management and hospital contracting also desirable.

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