Jurisdictional Analyst

Job not on LinkedIn

🔥 17 hours ago

🦀 Maryland – Remote

🦀 Maryland – Remote

💵 $30 - $55 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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LivantaLLC

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2004

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

Livanta LLC is a technology-enabled organization dedicated to advancing healthcare quality through innovation. It specializes in providing services to patients, caregivers, healthcare providers, and payers, focusing on improving health outcomes, navigating healthcare systems, and ensuring payment accuracy. Livanta is recognized as the largest Medicare Quality Improvement Organization and offers a range of services including quality oversight, auditing, advocacy, and data analytics to enhance patient care and safety while managing healthcare costs effectively.

📋 Description

• Determine whether a corporate conflict of interest prevents Commence from reviewing a dispute • Screen out cases covered by a prior decision involving the same parties within the 90-day cooling-off period • Determine whether regulatory timeframes required for jurisdiction have been met • Determine whether case jurisdiction is state or federal • Write appropriate jurisdictional determinations • Include relevant information for medical coders, nurses, and legal arbitrators when federal jurisdiction applies • Prioritize work and determine when to escalate issues, concerns, or discrepancies to the supervisor • Review medical records to assist in final IDR determinations • Apply knowledge of healthcare insurance functions and applicable state and federal medical and jurisdictional laws • Address potential issues proactively • Protect patient information in compliance with HIPAA and HITECH

🎯 Requirements

• Associates degree with a major in paralegal studies or a bachelor’s degree in legal services or business administration with a major in paralegal studies and/or a Paralegal certification; relevant experience can be substituted for formal training requirements • Excellent attention to detail, strong proofreading and organizational skills • Excellent oral and written communication with internal parties • Ability to simultaneously manage several projects, task functions, and complex contractual requirements • Proficient in Microsoft Office, including Word and Excel • Excellent organizational and time management skills • Clear, concise, and logical writing style • Ability to manage competing demands with differing deadlines and work well with attorneys, professionals, and other staff • Preferred: knowledge of insurance claims processing, medical coding, and claim rejections • Medical coding certification is preferred

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