StaffAssociate Attorney Job at CultivaHR, Detroit, MI

ay9xaDJsTjhEdXZyTUxwTGppeU14ZE92MGc9PQ==
  • CultivaHR
  • Detroit, MI

Job Description

Ternium is a leading provider of premium professional revenue cycle management services which resolves challenging healthcare insurance claim denials and delays to positive resolution for our partners. Our mission is to be the trusted partner of health systems and hospitals in their most challenging and complex areas of revenue cycle so that they may focus on what matters most patient care. With our professional and experienced staff we are able to scale our operating model to meet our partner s needs quickly driving superior results in net patient revenue and cash flows while reducing operating costs and improving the patient experience.

Description

As a Staff/Associate Attorney you will represent healthcare providers in their disputes with medical insurance carriers and managed care organizations across the full spectrum of administrative appeal processes. This is a nontraditional legal role whereby you will leverage your legal education in a variety of ways to include analytical analysis and issue identification contract reviews statutory research and application and persuasive appeal drafting. You will develop a foundational understanding of the industry and develop strong aptitudes in the areas of Commercial and Managed Care Insurance Claims policies and procedures and ERISA regulations as it relates to administrative processing of claims claim payment coverage determinations dispute resolution and other relevant concerns.

Responsibilities

  • Represent healthcare providers in denied claim disputes primarily shepherding disputes through an administrative appeals process (no litigation involved).
  • Develop innovative and novel legal and procedural arguments to effectuate positive resolution of denial medical claims.
  • Draft complex and persuasive appeal letters to insurance organizations and benefit administrators.
  • Leverage payor provider manuals and managed care contracts to successfully resolve denied medical claims.
  • Work directly with provider representatives and enhanced resolution units to successfully resolve complex issues.
  • Provide education payor trends denial trends and training of recovery staff team members at partner provider organizations.
  • Conduct legal research and analysis to support business model.

Requirements

  • Juris Doctor required
  • State Bar Membership (preferred)
  • Strong analytical and problemsolving skills
  • Excellent written and verbal communication skills
  • Ability to work independently and as part of a team
  • Attention to detail and the ability to prioritize within a dynamic environment
  • Ability to adhere to all HIPAA and company policies and regulations

Benefits

  • Fulltime
  • Remote
  • Starting salary $55000$65000 per year (commensurate with experience)
  • 401(k) with corporate match
  • Dental insurance
  • Employee assistance program
  • Flexible schedule
  • Health insurance
  • Vision insurance
  • Life insurance
  • Paid time off
  • Bar Due reimbursement
  • Bonus opportunities
  • The opportunity to grow personally and professionally with a dedicated and supportive team experiencing a tremendous growth

Ternium is dedicated to the fundamentals of equal employment opportunity. Ternium s employment practices including those regarding recruitment hiring assignment promotion compensation benefits training discipline and termination shall not be based on any person s age color national origin citizenship status physical or mental disability medical condition race religion creed gender sex sexual orientation gender identity and/or expression genetic information marital status status with regard to public assistance veteran status or any other characteristic protected by federal state or local law. Furthermore Ternium is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

Juris Doctor

Job Tags

Full time, Contract work, Local area, Remote job, Flexible hours,

Similar Jobs

Upstream USA

Policy Consultant (Contract Role Reproductive Healthcare) Job at Upstream USA

 ...mission of accessible patient-centered contraceptive care builds trust through empathy and honesty and contributes to a collaborative culture. They bring enthusiasm to their work creating opportunities for connection and celebration. Direct federal policy and advocacy... 

Cloud Analytics Technologies LLC

Cloud Architect with Anthos experience is must (Tarrytown, NY / Sleepy Hollow, NY (Onsite) Job at Cloud Analytics Technologies LLC

 ...Enterprise Kubernetes Platform (EKP), Container as a Service (CaaS) framework, and Backup/Disaster Recovery (DR) in a multi-cloud environment (AWS,Google Cloud Platform&Azure). This role covers hands-on technical delivery, solution governance, and project orchestration... 

Amazing Athletes

Amazing Athletes Multi-Sport/Fitness Coach Job at Amazing Athletes

 ...multi sport enrichment programs with over 50,000 kids enrolled each year! New Coaches can work 5-10 classes a week with a schedule that fits your needs. Our programs come with ready made curriculums and extensive training to help you get up to speed quickly and enjoy... 

Accordance Search Group

Clinical Education Specialist - Seattle Job at Accordance Search Group

 ...Job Description: Clinical Education Specialist Location: Seattle, WA Territory: covers Washington, Oregon, Alaska, and parts of Montana...  ...'s Degree in a relevant field (e.g., Nursing, Allied Health Sciences, Biomedical Engineering). Strong communication skills... 

City of Branson

Building Inspector II Job at City of Branson

We are looking for an Experienced Building Inspector! Put your construction and code knowledge to work inspecting all phases of building projects in Branson. From plan reviews to site inspections, no two days are the sameand your expertise helps keep our city safe and...