Health Insurance Staff Attorney/Associate – Client Liaison (Roseville/Sacramento, CA area)

Operations Roseville, California


Description

Convergent Revenue Cycle Management Inc.

Staff Attorney/Associate – Client Liaison

Summary
Convergent Revenue Cycle Management Inc., a company which specializes in health care reimbursement for hospitals all over the United States, is interviewing for a Staff Attorney/Staff Associate – Client Liaison position in the Roseville/Sacramento area. The selected candidate will sit remotely at one of our client sites and will report directly to a Supervising Attorney.

Responsibilities include, but are not limited to, working a caseload of 200 to 250 claims; contacting insurance companies to appeal wrongfully denied or underpaid insurance claims, utilizing federal and state laws and statutes to resolve claims, settlement negotiations, identifying client/payer issues, and maintaining a working knowledge of assigned client hospital and insurers. This position is transactional in nature; there is no litigation involved.  The selected candidate will also act as a liaison between Convergent, and its client (hospital).  Training will be provided.  

Duties

  • Draft substantive appeals and demands to insurance companies to ensure timely resolution and payment of claims
  • Argue verbally over the phone with insurance companies to get denials overturned and paid
  • Review contracts between hospitals and insurance companies in an effort to identify language that may be of assistance to client hospitals
  • Perform contractual analysis on paid claims to ensure that our client hospitals are reimbursed accurately and according to contract, and to ensure payment integrity
  • Formulate strong arguments necessary for settlement negotiations in favor of Convergent’s client hospitals
  • Liaise between client and Convergent team (voice/advocate)
  • Must work with the client to ensure the mutual success of our respective organizations.
  • Know how and when to involve key players in an account and effectively use internal employer resources to provide the best client solution
  • Identify and clearly articulate issues to be presented as feedback to hospitals in an educational setting
  • Complete post-meeting reports and summaries. Establish regular communication with clients regarding outstanding issues and program performance

 Requirements

  • JD degree required; bar admission preferred but not required
  • Experience in a client service representative, or a healthcare revenue cycle role is preferred but not required
  • Experienced with Microsoft Office include PowerPoint, Excel and Word
  • Candidate must have excellent oral and written communication skills
  • Individual must be high energy, creative, customer focused, proactive and action oriented
  • Must have demonstrated competency in working in teams, and ability to effectively communicate with all levels
  • Excellent interpersonal, oral and written communication skills
  • Ability to work independently
  • Outstanding organizational, analytical and problem-solving skills
  • Strong attention to detail
  • Ability to work well under pressure
  • Tact, and the ability to deal with difficult situations
  • Ability to travel 10-25%

Hiring is contingent upon successful background check and drug screening.

Compensation: negotiable based on experience. Please list your expected salary when applying for this position.



PM18