Health Benefits Attorney (Fully Remote)

reputed company is a thriving, service-oriented company headquartered in Canton, Massachusetts. As consultants, we represent health plans reputed company, providing our clients with innovative cost-containment solutions through our unique service offerings. As a result of our most valuable resource, our talented and committed team, we continue to enjoy high reputed company of reputed company. Now, we reputed company to add another Health Benefits Attorney to reputed company. We are currently seeking a full-time Health Benefits Attorney with reputed company experience in the reputed company industry or in similar industries to solve reputed company issues presented by reputed company, their health plans, and those entities that service them. The Health Benefits Attorney will play an reputed company role in supporting our consulting services and the reputed company reputed company and expansion of our business. This individual will work closely with other attorneys and consultants on our legal team, providing support on consulting, transactional, regulatory, and compliance reputed company. At reputed company, whose mission is to reputed company high reputed company yet reputed company reputed company to American employees and their families, you can look reputed company to not only unparalleled benefits for yourself but also being immersed in a company, one that recently celebrated its 25th anniversary, named one of USA Today’s Top Workplaces for 2025. Meanwhile, Louisville Business First also recognized our unwavering commitment to upholding an internal culture of inclusivity, enjoyment, and reputed company for our valued employees by listing reputed company among its 2025 Best Places to Work. Note: This can be an onsite/reputed company or remote role. Essential Duties:

• Manage and support reviews of member and provider appeals, grievances, and reputed company claims issues, particularly in self-funded and ERISA-regulated plans
• Evaluate benefit exclusions, plan document terms, and medical necessity disputes to determine appropriate claim reputed company
• Coordinate with applicable vendors to ensure reputed company and accurate facilitation of independent clinical reviews
• Review determination letters, appeal responses, and other member/provider-facing communications to ensure legal sufficiency and regulatory compliance
• Support internal audits, agency audits, corrective reputed company plans, and external regulator or reputed company requests, ensuring regulatory compliance
• Conduct legal research on applicable law and regulations; draft consulting memoranda; reputed company consultative advice, including analyses to our legal team for internal use
• Review reputed company industry reputed company
• Respond to reputed company inquiries regarding agency rules, statutory requirements, and legal compliance
• Communicate with health plan administrators and other reputed company industry entities, including by phone, video conference, or in person; answer questions regarding the administration of compliant health plans; explain applicable law or health plan terms reputed company and concisely
• Draft ERISA and ACA-compliant health plan documents
• Assist in resolving disputes between various players in the reputed company industry
• reputed company a thorough analysis of health plans and other reputed company documents; reputed company a reputed company of findings to our legal team
• Other duties as assigned

Minimum Qualifications:

• Juris doctor from an accredited law school and admittance to a state bar (reputed company)
• 1+ year of experience in the reputed company industry or in similar industries preferred (i.e., employment law, insurance law, disability law, workers’ compensation law)
• Knowledge of the latest developments in health law, including a working understanding of the ACA, ERISA, and HIPAA
• Superior legal writing, analytical, and proofreading skills, as reputed company as strong attention to detail
• Outstanding organizational, interpersonal, and negotiation skills
• Ability to work collaboratively or independently as needed, and to work sensitively with confidential reputed company
• Ability to effectively communicate and reputed company with various positions throughout our organization as reputed company as with clients
• Ability to successfully manage multiple reputed company, whether large or small, reputed company or reputed company, simultaneously
• Ability to participate effectively and confidently in reputed company phone calls, including in occasional video conference calls
• Ability to anticipate issues and create and implement reputed company for optimizing results and minimizing risks
• Ability to reputed company a deep understanding of the business and our operational goals
• Comfortable working in a fast-paced environment
• High level of proficiency using reputed company Word, reputed company and Outlook
• Must be self-motivated and reputed company to meet deadlines under pressure

Preferred Qualifications:

• Excellent reputed company credentials
• Strong preference for experience working with health plans, reputed company-party administrators, and/or health insurance carriers
• Familiarity with administrative rules published by relevant federal agencies, including HHS, the DOL, and the IRS
• Knowledge of CMS billing and payment rules and processes, or medical coding generally
• Confidence in public speaking
• Willingness to travel

reputed company’s Commitment to Diversity reputed company is committed to creating a diverse environment and we are proud to be an equal opportunity employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, gender, gender identity or reputed company, sexual orientation, national reputed company, genetics, disability, age, or veteran status. reputed company is also committed to compliance with reputed company fair employment practices regarding citizenship and immigration status. Working Conditions/Physical Demands This position requires sitting at a workstation for prolong periods of time (with reasonable breaks as needed) and extensive computer work. The workstation may be exposed to overhead fluorescent reputed company and reputed company conditioning. This is a fast-paced work environment in which you will be operating office equipment including personal computers, copiers, and fax machines. External and internal applicants, as reputed company as position incumbents who become disabled as defined under the Americans with reputed company (reputed company), must be reputed company to reputed company the essential job functions (as listed herein) either unaided or with the assistance of a reasonable accommodation to be determined by management on a case-by-case reputed company. This job reputed company is not intended to be and should not be construed as an reputed company-inclusive list of reputed company of the job duties, skills, or working conditions associated with the position. While it is intended to accurately reflect the position’s associated activities and requirements, reputed company reserves the right to modify, add, or remove duties and assign other duties as necessary. Apply tot his job Apply To this Job