Legal Associate

DRISCOLL HEALTH PLAN•Corpus Christi, TX

3d•Onsite

About The Position

The Associate Legal Counsel is a licensed attorney or experienced paralegal who performs general legal services for Driscoll Health System and its affiliated entities (DHS) under the oversight and direction of the General Counsel. This position will be responsible for representing Driscoll in insurance disputes and revenue cycle matters, litigation and will perform other legal duties as assigned.

Requirements

JD from an accredited law school and admitted to practice law in the state of Texas.
Excellent written, oral communication and presentation skills.
Ability to establish and maintain good communications with administration, medical staff, other departments and personnel.

Nice To Haves

Five years’ health care legal, regulatory or revenue cycle experience preferred.
Litigation experience strongly encouraged.

Responsibilities

Provide comprehensive legal services to DHS including legal interpretation, advice, and representation.
Provide professional interpretations of law and regulation and make recommendations on issues requiring legal analysis and resolution.
Provide professional interpretations and recommendations to DHS on issues requiring legal analysis and resolution.
Advise on regulatory and compliance issues, including Medicare and Medicaid requirements and reimbursement, anti-kickback issues, Stark law, and various other healthcare regulations.
Prepare, draft, and review legal documents.
Represent DHS in various litigation and regulatory matters, settlement conferences, mediation, arbitration and trial.
Draft demand letters, pleadings, and motions and take depositions or examinations.
Assist in discovery, including e-discovery
Managing litigation and investigations in conjunction with outside counsel
Oversee compliance with Medicare, Medicaid, and commercial payer regulations, including applicable billing and payment regulations and coding standards.
Enforce managed care contracts to ensure compliance with federal and state billing regulations.
Work directly with the DHS revenue cycle, medical coding, and clinical staff to secure accurate documentation required for aggressive claim recovery.
Pursue legal action against payors for violations of clean law laws and untimely or improper payment practices.
Work directly with Driscoll Health Plan in related claim disputes.
Represent DHS in mediations, arbitrations, or formal lawsuits related to payor agreements and other audits and disputes.
Maintain familiarity with legal and health care regulatory developments.
Draft, implement, and update institutional compliance policies and standard operating procedures.
Conduct internal investigations and represent Driscoll in regulatory, payor or government reviews or audits.
Assist with state licensure, Medicaid/Medicare enrollment and provider-based attestations.