Lien Negotiator

JOB TITLE:                          Lien Negotiator

REPORTS TO:                     CEO and CAO

REPORTS:                           N/A

GENERAL DESCRIPTION:

The Negotiator will be responsible for post-case medical bill negotiation.

DUTIES & RESPONSIBILITIES:

1. Negotiate and Settle Medical Liens – Work directly with medical providers, hospitals, and lienholders to negotiate reductions on outstanding medical bills, ensuring clients receive the maximum financial recovery.
2. Review and Analyze Medical Expenses – Gather, total, and verify all outstanding medical bills and lien amounts associated with resolved cases.
3. Obtain and Validate Final Lien Amounts – Communicate with Medi-Cal, Medicare, private health insurers, and third-party lienholders to secure accurate final balances.
4. Calculate Pro-Rata Reductions – Assess pro-rata distributions and determine appropriate reductions for multiple lienholders while maintaining compliance with settlement agreements.
5. Prepare Closing Statements and Settlement Disbursements – Draft detailed closing statements outlining all payments, disbursements, and negotiated reductions for final case resolution.
6. Ensure Compliance with Lien Resolution Laws – Stay up to date with state and federal regulations, including ERISA, Medicare, and Medi-Cal lien resolution procedures.
7. Maintain Clear Communication with Clients and Providers – Keep clients, attorneys, and medical providers informed throughout the lien resolution process, ensuring full transparency.
8. Collaborate with Internal Departments – Work closely with case managers, attorneys, and the accounting department to finalize settlements and coordinate payment distribution.
9. Resolve Lien Disputes – Address and resolve disputes with lienholders, providing supporting documentation and legal arguments to justify further reductions when applicable.
10. Track and Manage Case Workflow – Maintain an organized lien negotiation system, ensuring all deadlines are met, payments are processed timely, and follow-ups are completed efficiently.
11. Analyze and Improve Lien Negotiation Strategies – Continuously review settlement data and negotiation outcomes to enhance reduction strategies and maximize client recovery.
12. Handle High-Volume Case Load Efficiently – Manage multiple cases simultaneously in a fast-paced, high-volume environment while maintaining accuracy and attention to detail.

QUALIFICATIONS:

Qualified candidates will have 1-2 years related experience.  Knowledge or experience in the areas of insurance claims, personal injury, and or medical billing.  Outstanding customer service skills.  Must be a self-starter with professional phone etiquette. Excellent mathematical skills. Bilingual Spanish a plus.

EDUCATION and EXPERIENCE:

High school diploma or equivalent required, with some coursework. Associate degree preferred.  One year of related experience is required.

PHYSICAL REQUIREMENTS:

Prolonged periods sitting at a desk and working on a computer.  Must be able to lift up to 15 pounds at times. While performing the duties of this job, the employee is regularly required to stand, walk, sit; use hands to finger, handle or feel; reach with hands and arms.  The employee is frequently required to sit most of the working day.

POTENTIAL JOB HAZARDS

Potential for eye and wrist strain from the computer screen and minor lacerations from paper cuts.

SAFETY PRECAUTIONS REQUIRED

Demonstrated knowledge of safety procedures and Material Safety Data Sheets particular to departmental hazards. 

This job description is not intended to be all-inclusive and the employee will also perform other reasonably related duties as assigned by the Founder or CAO or his/her designee as needed.