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Years of Experience
Date Last Verified
Health Benefit Plan Administration - Attorney The candidate will solve issues presented by employers, their 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. Will be 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
The candidate should have J.D. Degree from an accredited law school and current admittance to a State Bar. Should have excellent academic credentials. Must have 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 administrative law, including IRS, DOL, and HHS, especially as it relates to employee benefit plans. High level of proficiency using Microsoft Word, Excel and Microsoft Outlook required. Outstanding organizational, interpersonal and negotiation skills is required. Excellent telephone, writing and proofreading skills is required. Proven record in managing cases involving Medicare and CMS, billing and payment rules and processes is desired. Past work within or related to the healthcare and insurance industries is desired. 3-5 years experience relating to: Health benefit plan administration; Hospital billing and payment rules and processes and Healthcare and ERISA law is desired. Experience with healthcare regulatory / agency law, including IRS, DOL, and HHS is desired.
Requisition ID : 1049
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