**Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.***This position is located Remote United States**This position requires working weekends, and rotating holidays as needed **Please note the start date is on or after July 6, 2026* Position Purpose:Provides legal representation for the company in administrative law judge (ALJ) hearings in the claims appeal process and provides quality and legal review of pre-adjudicated cases.
Essential Responsibilities:
- Participates in ALJ hearings as an attorney representative of the company in collaboration with the company's medical professionals and representatives from other Centers for Medicare & Medicaid Services (CMS) contractors.
- Reviews ALJ decisions and orders received from Office of Medicare Hearings and Appeals (OMHA), as required.
- Analyzes ALJ decisions received from OMHA for reconsideration decision quality purposes and provides training to decision makers to improve the quality of company decisions.
- Informs Medicare contractors of pending ALJ hearings to the extent required by joint operating agreements.
- Schedules and leads meetings with other Medicare contractors when pre-hearing coordination is required.
Minimum Qualifications
Education
- Juris Doctorate degree from an accredited law school
Membership- Active membership in state bar
Experience
- Three (3) years legal
- Medicare claims, preferred
- Participation in Administrative or Judicial proceedings, preferred
- Medicare Part C related appeals activities, preferred
- Resided in the United States for a minimum of three (3) years out of the last five (5) years? (Per Contract Requirement)
BenefitsC2C offers an excellent benefits package, including:
- Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
- Section 125 plan
- 401K
- Competitive salary
- License/credentials reimbursement
- Tuition Reimbursement
EOE Vet/Disability
