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Years of Experience
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.