Lien Negotiator / Hearing Representative (Workers' Compensation)

AM Lien Solutions•California - Remote, CA

34d•$75,000 - $110,000•Hybrid

About The Position

AM Lien Solutions is the leading California provider of lien resolution services. We offer a broad range of services including Lien and Litigation Management, Defense of 5811 Petitions, Specialized Bill Review, Medical Legal Dispute Resolution, Walk Through Lien Services, Medical Legal Record Review Preparation, Provider Fraud and Abuse Detection, and Continuing Education (CEU Training and Seminars). We serve Insurance Carriers, Third Party Administrators, Private Employers, and Public Entities. As a Lien Negotiator or Lien Hearing Representative at AM Lien Solutions, you will be responsible for the timely and accurate resolution of Workers’ Compensation lien claims on behalf of our clients. This includes reviewing medical and non-medical billing, assessing exposure, preparing files for negotiation or litigation, and ensuring compliance with applicable California Workers’ Compensation regulations and billing guidelines. Your work plays a vital role in reducing liability and supporting effective case resolution strategies.

Requirements

3 years of experience in lien defense within Workers’ Compensation (defense firm experience strongly preferred)
Solid understanding of California WCAB procedures, OMFS, MTUS, and EAMS
Strong organizational and time management skills
Excellent communication (written and verbal) and negotiation abilities
Familiarity with medical billing codes, provider profiling, and treatment authorization processes
Proficiency in systems such as A1, ProLaw, Merus, or PerfectLaw is highly preferred

Responsibilities

Review and analyze lien claims to assess validity, billing practices, and exposure.
Compare billed services to accepted body parts and treatment authorization; flag issues related to duplication, over-utilization, and unsupported charges.
Audit bills in line with the Official Medical Fee Schedule (OMFS), MTUS guidelines, and the DIR Drug Formulary.
Identify inappropriate billing (e.g., unbundled CPT codes, incorrect fee schedule application, overpricing, or off-formulary medications).
Research and document billing disputes to support negotiation or litigation.
Prepare case summaries, authority requests, and recommendations for resolution.
Organize findings in a manner that allows litigation or hearing representatives to proceed confidently with hearings if needed.
Negotiate settlements with lien claimants (e.g., interpreters, chiropractors, imaging centers) via phone or email.
Under guidance, participate in lower-complexity WCAB lien appearances or OTOCs.
Apply legal, medical, and technical knowledge to drive down settlement values.
Responsible for billing 8–10 hours per day, in accordance with established billing guidelines.
Ensure that time is logged accurately and that all billed activity reflects productive, client-facing work.
Any exceptions or non-billable tasks must be discussed with management in advance.
Billing compliance is a key performance metric and will be regularly reviewed by leadership.
Maintain accurate, detailed notes in the case management system.
Update internal databases and trackers regularly.
Submit timely, professional reports following established templates and protocols.
Assist in the preparation and e-filing of Discovery and Trial Exhibits, including the use of internal templates to ensure compliance with WCAB requirements.
Verify that documents are properly served and admissible.
Support Hearing Representatives with pre-trial documentation.
Participate in special assignments, including bulk settlements, client audits, and file closure projects.
Assist with intake or file audits as needed.