Healthcare Third Party Liability Regulatory Specialist

Profile

Healthcare Third Party Liability Regulatory Specialist
Duties: Identify, research, understand state and Federal laws and regulations that impact eligibility and claiming integrity products and services Collaborate with and provide recommended actions to senior management in addressing potential legal and/or regulatory roadblocks to business objectives Identify, track, and document significant government and private stakeholders in the eligibility marketplace in order to: and establish collaborative eligibility and claim data sharing relationships. Negotiate data-sharing, trading partner, and other necessary agreements. Proactively resolve concerns, disputes, and escalations Remain informed of legal changes, guidelines, and judgments from healthcare industry that could impact Healthcare Support Healthcare Operations with ad hoc scenarios where regulations, state laws, or Federal laws intersect, including general escalation assistance for operational issues and/or disputes Collaborate with General Council, Compliance, and senior business leadership in drafting and refining contracts, policies, procedures, and other business collateral Propose healthcare operational or relational enhancements to the organization from a legal or regulatory perspective, included but not limited to the Third-Party Liability (TPL) and Reclamation teams, Medicare Secondary Payer (MSP), and Coordination of Benefits (COB). Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.

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