Description:

Welcome! We're excited you're exploring opportunities with us. Below you'll find details about the role, the impact you can make, and what we're looking for in an ideal candidate. We're passionate about building a team that shares our values and brings diverse perspectives to help us grow and succeed together.

Senior Associate - Attorney (Remote)

Join Our Team at Ternium – A Leading Advocate in Healthcare Revenue Solutions!

Are you an experienced healthcare attorney looking for a rewarding career outside the traditional law firm environment? Do you thrive on solving complex reimbursement challenges, crafting persuasive legal arguments, and helping healthcare providers recover revenue they have rightfully earned? If so, Ternium wants to hear from you

Who We Are:
At Ternium, we specialize in resolving complex healthcare insurance claim denials and delays. Our mission is to empower hospitals and health systems by optimizing their revenue cycle, allowing them to focus on what matters most—patient care. With a dedicated team of professionals, we consistently deliver outstanding results, increasing net patient revenue, improving cash flow, and reducing operational costs while enhancing the patient experience.

What You'll Do:
As a Senior Associate - Attorney, you will serve as a highly experienced individual contributor responsible for managing a complex, high-volume caseload of insurance appeals on behalf of hospitals and healthcare providers. Leveraging your expertise in healthcare reimbursement, payer contracts, and administrative appeals, you will develop sophisticated legal strategies that maximize reimbursement outcomes while helping shape best practices across the organization.

While this role does not include direct people management responsibilities, you will serve as a subject matter expert, sharing knowledge and providing guidance to colleagues while contributing to the continuous improvement of appeal strategies and recovery efforts

Key Responsibilities:

Manage a high-volume caseload of complex administrative appeals for denied healthcare insurance claims.
Draft compelling, well-supported appeal letters, reconsideration requests, and other legal correspondence to commercial and government payers.
Analyze managed care contracts, provider manuals, medical policies, federal and state regulations, and payer guidelines to develop effective reimbursement strategies.
Research complex legal, contractual, and regulatory issues impacting healthcare reimbursement.
Partner with clinical review nurses, resolution specialists, and client representatives to develop comprehensive appeal strategies.
Identify denial trends, payer behaviors, and emerging reimbursement issues while providing recommendations to improve recovery outcomes.
Develop written client communications, legal analyses, and industry insights related to reimbursement trends and regulatory developments.
Maintain productivity and quality standards while independently managing competing priorities in a remote environment.
Ensure compliance with HIPAA, client confidentiality requirements, and all applicable federal and state regulations

What you bring to the table: