Hearing Representative - Workers' Compensation

Ethos; Lake Forest (CA); Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Hybrid or on-site options

Office: Lake Forest, CA

Job summary

Ethos Risk Services in California is hiring a full-time Hearing Representative to manage lien resolution within the California workers' compensation system. You will represent clients at WCAB proceedings, negotiate settlements, and prepare legal documents and exhibits.

We seek 2–5 years’ relevant experience, strong negotiation, analytical, and communication skills, and the ability to handle complex reimbursement issues in a fast-paced environment. Hybrid/onsite in Lake Forest, CA.

Qualifications

• 2–5 years of experience in workers' compensation or legal support (required).
• Experience with California lien procedures and WCAB proceedings (required).
• Experience preparing hearing exhibits and resolving provider disputes (preferred).
• Experience with Conduent Strataware software (preferred).

Responsibilities

• Attend WCAB hearings and manage lien conferences, settlements and status conferences.
• Represent clients during lien proceedings and administrative hearings.
• Negotiate settlements to resolve disputed liens and obtain favorable outcomes.
• Review provider appeals, reconsideration requests and disputed lien claims.
• Draft minutes of hearing, appeal responses and hearing exhibits.
• Research California workers' compensation statutes, fee schedules and case law.
• Support attorneys with hearing preparation and litigation tasks.
• Analyze workers' compensation medical bills and reimbursement disputes.
• Maintain accurate case documentation and meet deadlines.
• Collaborate with claims, bill review teams, providers and attorneys.

Skills

Negotiation

Conflict resolution

Written communication

Verbal communication

Medical billing analysis

Regulatory issues

Organizational skills

Time management

Prioritization

Education

High school diploma or equivalent

Associate's degree or higher

Tools

Conduent Strataware

Job description

About Us

Ethos Risk Services is a leading provider of workers' compensation medical management, investigations, and claims solutions, dedicated to helping clients make better decisions through industry expertise, innovation, and exceptional service. As we continue to grow, we're expanding our cost containment capabilities through

About Us

Ethos Risk Services is a leading provider of workers' compensation medical management, investigations, and claims solutions, dedicated to helping clients make better decisions through industry expertise, innovation, and exceptional service. As we continue to grow, we're expanding our cost containment capabilities through Definiti, a national leader in medical bill review, pharmacy benefit management, PPO network solutions, and reimbursement services. Together, we're building a comprehensive suite of solutions that helps clients reduce costs, improve efficiency, and achieve better claim outcomes.

Job Summary

Our dynamic Bill Review team is seeking a full-time Hearing Representative to represent our organization and clients throughout the California workers' compensation lien resolution process. This role is responsible for resolving complex lien disputes, negotiating settlements, preparing legal documentation, and supporting administrative hearings while partnering closely with providers, attorneys, claims professionals, and bill review teams.

Our ideal candidate has experience in California workers' compensation, strong analytical and negotiation skills, and enjoys solving complex reimbursement challenges in a fast-paced environment.

Key Responsibilities

• Attend Hearings - Participate in California Workers' Compensation Appeals Board (WCAB) lien conferences, settlement conferences, status conferences, and lien trials while representing client interests.
• Represent Clients - Advocate on behalf of Ethos and its clients during lien proceedings, negotiations, and administrative hearings.
• Negotiate Settlements - Work directly with providers, attorneys, and hearing representatives to resolve disputed liens and achieve favorable settlement outcomes.
• Review & Resolve Appeals - Evaluate provider appeals, reconsideration requests, and disputed lien claims while identifying appropriate resolutions.
• Prepare Legal Documentation - Draft Minutes of Hearing, appeal responses, hearing exhibits, and other supporting legal documentation.
• Research Regulations - Interpret California workers' compensation statutes, fee schedules, regulations, and case law to support case strategy and compliance.
• Support Litigation - Assist attorneys with hearing preparation, case analysis, and litigation support activities.
• Perform Technical Bill Review - Analyze workers' compensation medical bills, reimbursement issues, and complex payment disputes.
• Manage Complex Cases - Maintain accurate documentation, prioritize multiple cases, and ensure deadlines are consistently met.
• Collaborate Across Teams - Partner with claims professionals, bill review operations, providers, attorneys, and internal stakeholders to deliver timely and effective claim resolutions.

Qualifications

Education

High school diploma or equivalent (required). Associate's degree or higher is preferred.

Experience

• Minimum of 2 to 5 years of experience in workers' compensation, legal assistant, paralegal, claims, hearing representative, lien resolution, litigation support, or related experience (required).
• Experience with California's workers' compensation lien procedure and regulations (required).
• Experience attending WCAB proceedings, negotiating liens, preparing hearing exhibits, responding to provider disputes, and handling appeals (preferred).
• Experience preparing legal exhibits and hearing documentation (preferred).
• Experience in Conduent Strataware software (preferred).

Certifications

Certification in medical cording or medical terminology (preferred).

Skills

• Excellent negotiation and conflict resolution skills
• Strong written and verbal communication
• Ability to analyze medical billing, reimbursement, and regulatory issues
• Excellent organizational, time management, and prioritization skills

Working Conditions

This position offers flexible work arrangements, including hybrid or full on-site options, based on business needs and management approval. The office is located at 26445 Rancho Parkway Street, Lake Forest, CA 92630. Flexible start times are available between 6:00 a.m. and 9:00 a.m., with eligibility for a 9/80 alternate work schedule (every other Monday or Friday off) following successful completion of training, satisfactory performance, business needs, and management approval. Occasional travel and overnight stay may be required to attend California Workers' Compensation Appeals Board (WCAB) proceedings.

Ethos Risk Services and Definiti Comp Solutions is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristic.