• Location: Irvine, California
• Type: Direct Hire
• Job #977
• Salary: $250,000 - $360,000

Commercial Litigation Associate (3-5 year)
Location(s): Orange County, CA
Salary Range: $250,000 – $360,000
Admission: California
Schedule: 3 days/week Onsite

Client Size: 4,000+

Client Description:
Our client is one of the largest law firms in the world with over 45 offices across 5 continents.  They offer clients local market knowledge and access to both national and international capabilities. They represent a broad array of leading global corporations and emerging growth companies, as well as public sector entities, educational institutions, philanthropic organizations, and individuals. They foster an inclusive and collaborative environment across their fully integrated global platform that enables them to diligently combine the knowledge and expertise of their lawyers and policy professionals to create teams that provide exceptional client solutions.

Position Description:
Our client is seeking a midlevel associate to join the Commercial Disputes practice in our dynamic Orange County office. The ideal candidate will have three to five years of health care litigation experience, preferably in payor-provider litigation. The successful candidate will demonstrate exceptional legal analysis, strategic thinking, and advocacy skills.

Responsibilities:

• Health care claims, including contents, processing and appeals terminology (CPTs, HCPCS, DRG), 
• Ability to analyze communications between providers and insurers, including denial and approval letters,
• Analysis of key contract provisions and provider manuals between health care systems and insurers,
• Review and interpret Summary Plan Descriptions, including reimbursement language, anti-assignment provisions, and medical necessity definitions,
• Ability to review administrative records for claims, including ability to identify category of denials and underpayments (including medical necessity, DRG downgrade, ED downgrades), as well as appeals information and account notes,
• Ability to review claims detail in Microsoft Excel, with ability to sort, use pivot tables and v-lookup functions, and
• Ability/familiarity with extrapolation methodologies a plus but not required.

Qualifications:

• Juris Doctor (J.D.) degree from an accredited law school.
• Admission to California State Bar and in good standing.
• Excellent written and verbal communication skills.
• Ability to work independently and as part of a team in a fast-paced environment.
• Commitment to delivering high-quality legal services and achieving favorable outcomes for clients.