Medicare Appeals Staff Lawyer at Columbia

Job Description

Division#:

Division Name:

Job Categories: Government, Health Care, Legal

Job Responsibilities: Job Responsibilities

Job Responsibilities:

Identify the legal, factual and policy issues to be addressed in Medicare administrative appeals. Research issues and write legal memoranda supporting Medicares position.

Evaluate appeals decisions, advise on the interpretation and application of Medicare laws and regulations and provide strategies to promote consistency in the appeals process and reduce the number of claim reversals.

Coordinate Medicare contractors efforts to ensure that CMS perspective is represented effectively at ALJ hearings.
The Ideal Candidate will Possess the Following Additional Education, Experience, and Abilities:

Jurist Doctor (JD) OR Bachelor of Legal Letters (LL.B).

Three years Medicare-related work preferred.

Requires subject matter expertise in Medicare law and policy or the ability to learn quickly.

Demonstrated excellent research and writing skills.

Ability to build and maintain constructive relationships with management, Medicare contractors and client.
MAXIMUS (NYSE:MMS) is a leading health and human services administrator for governments in the United States, United Kingdom, Canada and Australia. We deliver administrative solutions to improve the cost effectiveness, efficiency and quality of government-sponsored benefit programs across the globe. Operating under our founding mission of Helping Government Serve the People, we have more than 7,000 employees located in more than 220 offices worldwide. MAXIMUS is an Affirmative Action and Equal Opportunity employer.

Education Required: Bachelors Degree from an accredited college or university or equivalent experience

Technical Skills / Knowledge Required: Proficient in Microsoft Office (Word and Excel)

Subject Matter Expertise/Experience Required: Four years related experience in either healthcare, human services, public finance, education and or technology
Subject Matter Expertise/Experience Preferred: Four to eight years Professional services consulting experience

Personal/Soft Skills: Excellent organizational, interpersonal, verbal, and written communication skills, ability to perform comfortably in a fast-paced, deadline oriented work environment, ability to successfully execute many complex tasks simultaneously, ability to build relationships with external cliental and ability to work as a team member, as well as independently

Duties/Responsibilities:
1. Supports projects/initiatives by producing project deliverables which fall within scope of work requirements
2. Recommends changes to project/specific initiatives
3. Works on issues where analysis of situation of data requires review of relevant factors: Exercises judgment within defined procedures and policies to determine appropriate action
4. Gains cooperation of all project stakeholders
5. Participates in client meetings; develops trust, credibility, and strong client relationships; and seeks opportunities to add value above and beyond competitors
6. Attends Division and Corporate meetings as requested and required
7. Responds to client inquires and concerns
8. Conduct presentations of technical information concerning specific projects or schedules
9. Performs other duties as may be assigned by management

MAXIMUS offers a comprehensive benefits package including:

Healthcare Insurance (medical, dental, vision)

Short and Long Term Disability Insurance

Life/Accident Insurance

Flexible Spending Accounts (FSA)

401(k) Retirement Plan with company match
Our benefit program also includes paid holidays, PTO, tuition reimbursement, and supplemental insurance (auto and pet insurance discounts, legal plan, and credit union).

Relocation offered where applicable

Job Requirements

 
Country: USA, State: South Carolina, City: Columbia, Company: Maximus.