Counsel-TPA Operations

Posted 2 Days Ago
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Blue Bell, PA, USA
Hybrid
Senior level
Insurance • Professional Services
The Role
Provides legal and regulatory counsel for TPA operations, including commercial contracts, RFPs, vendor agreements, licensing, regulatory examinations, disputes, and legal process improvement. Manages paralegal or contract-administration resources, develops templates and approval guardrails, advises business leaders on risk, and coordinates specialty legal support for complex matters.
Summary Generated by Built In
Job Summary & ResponsibilitiesPOSITION SUMMARY

The Counsel - TPA Operations is a hands-on attorney responsible for recurring business-facing legal and regulatory work for the Lodestar TPA. The position performs substantive legal work, manages paralegal or contract-administration resources, and improves existing processes.

Although aligned within Claim Operations, the position supports the Lodestar TPA enterprise. Counsel enables business-led contracting through templates, approved language, guardrails and exception criteria; business leaders retain ownership of customer relationships, commercial negotiations and operating commitments. Counsel coordinates with shared-service and specialty legal resources when needed.

ESSENTIAL DUTIES AND RESPONSIBILITIESLegal Advice and Business Partnership
  • Provide independent, practical legal advice and distinguish legal or regulatory requirements from commercial considerations.
  • Communicate material risk, options and recommended action while preserving business ownership of commercial and operating decisions.
Contracts, RFPs and Business Support
  • Create and maintain standard customer agreements, amendments, renewals, exhibits, clauses and negotiation guidance.
  • Enable business leaders to negotiate routine terms within approved templates and guardrails; review, draft and negotiate defined exceptions and material deviations.
  • Review vendor agreements, RFPs, proposals and due-diligence responses for material legal or regulatory issues and identify matters requiring specialized review or escalation.
  • Advise on contract interpretation, obligations, remedies and material commitments, and standardize responses to recurring legal questions.
Legal Operations and Resource Management
  • Assume responsibility for legal intake, review, approval, execution, recordkeeping and matter tracking while maintaining business continuity.
  • Improve processes through standards, exception criteria, templates, playbooks, controls and escalation protocols; report on workload, exceptions, significant risks and service levels.
  • Manage and prioritize paralegal or contract-administration resources, delegating execution while retaining legal accountability and quality standards.
Regulatory, Licensing and Examinations
  • Own the TPA regulatory licensing function, including renewals, registrations, appointments and related filings, with administrative support from the paralegal.
  • Interpret regulatory requirements, advise leadership on material developments, and lead or coordinate inquiries, examinations and remediation.
  • Coordinate with Claim Operations on compliance, adjuster licensing and related responsibilities to ensure clear accountability and escalation.
Commercial Disputes and Specialty Legal Support
  • Own or coordinate routine commercial and contract disputes, interpretation issues and early resolution efforts.
  • Engage shared-service or specialty legal resources for litigation, E&O, high-risk disputes, privacy and cybersecurity, employment, governance, novel matters or matters outside delegated authority; serve as TPA coordinating attorney when appropriate.
Decision Authority and Governance
  • Determine applicable legal and regulatory requirements, provide independent analysis and recommend appropriate action.
  • Business leaders retain decision authority for commercial and operating matters within delegated authority and remain accountable for business commitments.
  • Routine agreements within approved templates and guardrails do not require substantive legal approval; defined exceptions and material deviations do.

#LI-Hybrid

Preferred QualificationsREQUIRED QUALIFICATIONS
  • Juris Doctor (J.D.) degree from an accredited law school.
  • Active bar membership in good standing in at least one U.S. jurisdiction and ability to obtain and maintain required in-house registration or limited licensure.
  • Minimum 5 years of relevant legal experience; 5-8 years preferred.
  • Substantial experience with commercial agreements, practical legal and regulatory advice, and independent legal analysis.
  • Experience managing or effectively using paralegal or contract-administration resources.
PREFERRED QUALIFICATIONS AND COMPETENCIES
  • Experience in TPA operations, insurance, claims administration or another regulated environment, including licensing or regulatory examinations.
  • Experience developing contract templates, playbooks, approval guardrails and exception-based legal review.
  • Strong commercial judgment, drafting and negotiation skills, and ability to translate risk into practical business advice.
  • Ability to operate independently, manage priorities, determine when legal involvement adds value and work effectively across the business.

 

Skills Required

  • Juris Doctor degree from an accredited law school
  • Active bar membership in good standing in at least one U.S. jurisdiction
  • Ability to obtain and maintain required in-house registration or limited licensure
  • Minimum 5 years of relevant legal experience
  • Substantial experience with commercial agreements, practical legal and regulatory advice, and independent legal analysis
  • Experience managing or effectively using paralegal or contract-administration resources
  • Experience in TPA operations, insurance, claims administration, or another regulated environment, including licensing or regulatory examinations
  • Experience developing contract templates, playbooks, approval guardrails, and exception-based legal review
  • Strong commercial judgment, drafting and negotiation skills, and ability to translate risk into practical business advice
  • Ability to operate independently, manage priorities, determine when legal involvement adds value, and work effectively across the business
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The Company
15 Employees
Year Founded: 2023

What We Do

Lodestar Claims & Risk Services, Inc. is a national Third Party Administrator (TPA) that provides comprehensive claims management, risk services, and client support. The company focuses on delivering responsive, results-driven claims services while fostering a culture of accountability, professional growth, and a people-first approach. They act as a trusted partner to their clients, simplifying complex claims processes and protecting people through expertise and critical thinking.

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