Welcome to the jobs section of the BCG Attorney Search Web site. We are constantly updating our jobs seven days a week. As a firm dedicated to research, our ability to forge strong relationships with law firms allows us to offer our candidates a breadth of opportunities that we believe is unrivaled anywhere.
Towson office of our client seeks associate attorney with 1-2 years of healthcare experience. The candidate will represent and counsel healthcare providers in their disputes with medical insurance carriers and managed care organizations at all stages of the administrative appeals process. Responsibilities include: initial reviews, calling insurance companies to resolve authorization and claim denials, writing appeals and letters to insurance companies to resolve denials, and following up on appeals to the point of exhaustion or payment. Represent healthcare providers in the defense of third party payer audits. Provide defense of health care entities at all stages of the administrative appeals process. Assist hospitals in resolving denied and underpaid facility claims. Handle compliance matters between the providers and insurance companies. Draft complex and contractual appeals and letters to insurance companies. Review and apply client contract language and rates as necessary to resolve denied claims. Utilize payer provider and administrative manuals to dispute denied claims. Maintain an understanding of Maryland Health Services Cost Review Commission (HSCRC) payment rules. Maintain an understanding of DRG, per diem, case rates and other relevant insurance reimbursement schematics. Apply provider specific reimbursement methodologies, payment policies and provider contracts to each payment reviewed to confirm payment in full. Maintain an understanding of Electronic Remittance Summary Posting. Follow all HIPAA guidelines in accordance with the Fotheringill and Wade, LLC Policy, Procedure, and Security Manual. Maintain expert understanding of Medicare and Medicare Advantage regulations regarding payment, coverage, conditions of participation, and other relevant topics. Represent clients during Administrative Law Judge hearings and attend administrative hearings for claim denials by Maryland Medicaid. Should be admitted to practice law in the State of Maryland.
This law firm was founded over a decade ago and focuses on counseling and representing hospitals. Their areas of practice include coding denials, government denials, medicare advantage denials, consulting, and commercial or managed care details. The firm is located in Baltimore, MD.