In-House Counsel

About this role: 

As In-House Counsel, you will oversee the legal aspects of our revenue cycle operations, including aged claims, appeals, Independent Dispute Resolution (IDR) processes, payer negotiations, and compliance with healthcare reimbursement laws and payer policies. This key strategic role blends legal expertise with practical business and operational understanding.

Key Responsibilities:

Aged Claims & Appeals:

• Advise on the legal strategy for recovering aged and denied claims.
• Draft escalated appeal letters and responses to payers and third-party administrators.
• Monitor appeal timelines and support escalation as needed.

IDR Billing & Dispute Resolution:

• Lead and manage Independent Dispute Resolution (IDR) processes under federal and state regulations (e.g., No Surprises Act).
• Collaborate with operations and client success teams to assess IDR eligibility, prepare filings, and advocate on behalf of provider clients.

Regulatory & Compliance Oversight:

• Ensure compliance with federal, state, and payer-specific reimbursement regulations.
• Provide guidance on HIPAA, ERISA, and other applicable healthcare laws.