Fractional Healthcare Attorney - CBO/RCM
About The Position
KPC HQ, LLC is seeking an experienced Fractional Healthcare Attorney to provide strategic legal counsel and regulatory guidance supporting the Central Business Office (CBO), Revenue Cycle Management (RCM), and related operational functions across KPC's seven affiliated acute care hospitals. This position serves as a trusted advisor to executive leadership by providing legal guidance on healthcare operations, reimbursement, revenue cycle management, managed care contracting, regulatory compliance, and operational risk. The attorney will work collaboratively with Finance, Compliance, Patient Financial Services, Health Information Management (HIM), Case Management, and hospital leadership to develop practical, legally sound solutions that support organizational objectives while minimizing legal and regulatory risk.
Requirements
- Thorough knowledge of federal and California healthcare laws and regulations affecting hospitals and healthcare organizations.
- Strong understanding of hospital revenue cycle operations, reimbursement methodologies, patient financial services, billing, collections, denials management, and payer contracting.
- Knowledge of healthcare compliance requirements, including HIPAA, Medicare, Medi-Cal, the Stark Law, the Anti-Kickback Statute, EMTALA, and the False Claims Act.
- Excellent legal research, analytical, negotiation, and problem-solving skills.
- Ability to communicate complex legal and regulatory concepts in a practical, business-focused manner.
- Strong written, verbal, interpersonal, and presentation skills.
- Excellent organizational skills with the ability to manage multiple priorities and deadlines.
- Ability to exercise sound legal judgment while maintaining strict confidentiality.
- Proficiency in Microsoft Office applications and legal research resources.
- Juris Doctor (J.D.) from an accredited law school.
- Active license to practice law in the State of California in good standing.
- Minimum of seven (7) years of progressively responsible healthcare legal experience.
- Experience advising healthcare organizations on healthcare operations, regulatory compliance, reimbursement, revenue cycle management, or managed care matters.
- Experience drafting, reviewing, and negotiating healthcare-related contracts and business agreements.
Responsibilities
- Provide legal counsel to executive leadership regarding healthcare operations, revenue cycle management, reimbursement, billing, collections, patient financial services, and related operational matters.
- Advise leadership on compliance with applicable federal and California healthcare laws and regulations, including reimbursement requirements, healthcare privacy, fraud and abuse laws, and hospital operational requirements.
- Review and analyze revenue cycle processes to identify legal, regulatory, and operational risks, and recommend practical solutions.
- Draft, review, negotiate, and interpret managed care agreements, vendor contracts, business associate agreements, and other legal documents supporting hospital operations.
- Provide legal guidance regarding reimbursement matters, payer disputes, denials, payment recovery, audits, overpayments, appeals, and related revenue cycle initiatives.
- Assist executive leadership in responding to regulatory inquiries, governmental audits, investigations, and compliance matters involving reimbursement or healthcare operations.
- Monitor changes in healthcare laws, regulations, and reimbursement requirements, and advise leadership regarding operational impacts and compliance strategies.
- Collaborate with executive leadership, Finance, Compliance, Patient Financial Services, HIM, Case Management, and hospital leadership on legal issues affecting healthcare operations and revenue cycle performance.
- Provide legal support for organizational policies, operational initiatives, business strategies, and process improvement efforts.
- Conduct legal risk assessments and provide recommendations to support informed business decisions.
- Coordinate with outside legal counsel on specialized legal matters, litigation, or regulatory issues when appropriate.
- Attend leadership meetings and provide legal guidance on strategic initiatives and operational projects, as requested.
- Perform other duties as assigned.
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What This Job Offers
Career Level
Senior
