Healthcare Claims Attorney – Appeals & Settlements

ADP, Inc.; Washington (District of Columbia); Hybrid; USD 65,000 - 80,000; Full time

Benefits offered by this job

Health insurance stipend

401(k) retirement plan

Paid time off

Professional development

Life and disability insurance

Job summary

Healthcare Legal Solutions, LLC in Washington, DC is seeking an attorney to settle a high volume of medical claim appeals and manage a large corporate health claim caseload, including drafting written appeals to health insurers and governmental payers.

The role requires a JD with 3+ years in healthcare or administrative law, strong writing, and proficiency in Word/Excel. After a probationary period, a hybrid work arrangement is available along with a comprehensive benefits package.

Qualifications

• Juris Doctoral Degree from an ABA-accredited law school.
• Licensed to practice in at least one U.S. jurisdiction (DC, MD, VA, or PA preferred).
• Law school GPA of 3.0 or higher.
• 3+ years of legal experience, ideally in healthcare or administrative law.
• Proficiency in Microsoft Office, including Word and Excel.
• Highly attentive to detail and able to handle large amounts of paperwork for a busy office.
• Clear, concise, and logical writing style.
• Excellent organizational and time management skills.

Responsibilities

• Review medical records and submit well-written compelling appeals to health insurers and governmental payers.
• Write demand letters and negotiate settlements from large corporate payers.
• Apply understanding of regulatory areas to support appeal arguments (Commercial, Governmental, Managed Care, ERISA).
• Assist legal appeals team in developing new and innovative legal arguments and tools.
• Oversee drafting of complex contractual appeals and templates for organizational use.
• Guide legal interns and paralegals when needed.
• Perform administrative duties or projects as assigned by leadership.
• Navigate through various insurance systems and applications to find information about claims.
• Follow all HIPAA guidelines and internal compliance protocols.

Skills

Attention to detail

Writing skills

Time management

Verbal communication

Education

Juris Doctor (J.D.)

Tools

Microsoft Word

Microsoft Excel

Job description

Healthcare Legal Solutions, LLC in Washington, DC is seeking an attorney to settle a high volume of medical claim appeals and manage a large corporate health claim caseload, including drafting written appeals to health insurers and governmental payers.

The role requires a JD with 3+ years in healthcare or administrative law, strong writing, and proficiency in Word/Excel. After a probationary period, a hybrid work arrangement is available along with a comprehensive benefits package.