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

Unique Ornamental Iron

Iron Fabricator/Iron Fence Installer Job at Unique Ornamental Iron

 ...assemble our clients ornamental wrought iron needs. Responsibilities: Weld and fabricate wrought iron/ornamental iron gates, fences, etc. Install fences, gates, etc. Able to run a crew when needed Calculate material measurements to specifications.... 

TLC Healthforce

Travel Licensed Practical Nurse LPN Job Job at TLC Healthforce

Embark on a rewarding journey as a Licensed Practical Nurse (LPN) in Utica, New York, where your hands-on care and compassionate presence...  ...the lives of patients and families during every shift. This travel-facing opportunity is designed for LPNs who want to deepen their... 

Vitaly Health

Locum Tenens - Gastroenterology Physician Job at Vitaly Health

 ...Job Title: Locum Tenens - Gastroenterology Physician Location: Wisconsin State Position Overview: Our team at Vitaly Health is looking for a Gastroenterology Physician to join our Medical Center on an ongoing Locum Tenens basis, with a start date of September... 

Champions Funding LLC

Sales Assistant Job at Champions Funding LLC

 ...and operational support to the sales team, including Account Executives and Sales Leaders. Solicit new prospective clients and target new prospects. Outbound sales solicitation via phone, email and marketing strategies. Schedule appointment presentations of our... 

Hillcrest Healthcare System

Ultrasound Tech Job at Hillcrest Healthcare System

 ...services, urology, ENT, gastroenterology, cardiology, orthopedics, general surgery and wound care. Responsibilities: Operate the ultrasound scanners. Transporting patients to and from the department. Scheduling patients, answering questions, and calling exam...