Provider Appeals Liaison

A company is looking for a Provider Appeals and Legal Liaison.

Key Responsibilities

Serve as the main liaison between Medical Bill Review, Complex Claims, and Legal for provider dispute resolutions

Draft and refine responses to legal teams and maintain knowledge of Workers' Compensation standards

Identify trends in provider disputes and support internal training initiatives

Required Qualifications

Bachelor's degree or equivalent experience; advanced coursework in healthcare administration, legal studies, or medical billing preferred

Minimum 7 years of national Workers' Compensation bill review experience, including 3 years in appeals or legal coordination

Advanced understanding of medical billing, coding, and Workers' Compensation regulations

Proficiency in Microsoft Office and bill review platforms

Strong analytical and critical thinking abilities