Attorney (Part C)

Tmf/C2C • Austin, TX

13h • Remote

About The Position

This position provides legal representation for the company in administrative law judge (ALJ) hearings in the claims appeal process and provides quality and legal review of pre-adjudicated cases.

Requirements

• Juris Doctorate degree from an accredited law school
• Active membership in state bar
• Three (3) years legal Medicare claims
• Resided in the United States for a minimum of three (3) years out of the last five (5) years? (Per Contract Requirement)

Nice To Haves

• Participation in Administrative or Judicial proceedings
• Medicare Part C related appeals activities

Responsibilities

• Participates in ALJ hearings as an attorney representative of the company in collaboration with the company’s medical professionals and representatives from other Centers for Medicare & Medicaid Services (CMS) contractors.
• Reviews ALJ decisions and orders received from Office of Medicare Hearings and Appeals (OMHA), as required.
• Analyzes ALJ decisions received from OMHA for reconsideration decision quality purposes and provides training to decision makers to improve the quality of company decisions.
• Informs Medicare contractors of pending ALJ hearings to the extent required by joint operating agreements.
• Schedules and leads meetings with other Medicare contractors when pre-hearing coordination is required.

Benefits

• Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
• Section 125 plan
• 401K
• Competitive salary
• License/credentials reimbursement
• Tuition Reimbursement

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level