Senior Counsel - Denials & Payor Litigation

Senior Counsel - Denials & Payor Litigation

Community Hospital | On-Site, Grand Junction, Colorado
Hiring Range: $75.00-$86.25/hour | $156,000-$179,400 annually

Community Hospital is seeking an experienced Senior Counsel - Denials & Payor Litigation to provide strategic legal leadership in healthcare reimbursement, payer disputes, and revenue protection. This position addresses complex denials, underpayments, recoupments, audits, and payment disputes involving commercial insurers, government payers, third-party administrators, and other reimbursement entities.

This is an opportunity for an experienced healthcare attorney to work at the intersection of law, finance, reimbursement, and hospital operations, partnering with Revenue Cycle, Patient Financial Services, Finance, Clinical Documentation, Coding, Compliance, Contracting, Medical Staff, and executive leadership.

What You'll Do

As Senior Counsel, you will help protect Community Hospital's financial interests by identifying significant and systemic payer issues and developing legal strategies to maximize appropriate reimbursement.

Key responsibilities include:

• Provide legal counsel regarding complex and high-value hospital claim denials, underpayments, recoupments, payment delays, and other payer disputes.
• Review and interpret payer contracts, reimbursement methodologies, applicable laws and regulations, and payer policies.
• Develop strategies to recover unpaid, improperly denied, or underpaid claims.
• Partner with Revenue Cycle and Finance to prioritize high-dollar and strategically significant reimbursement disputes.
• Analyze denial and underpayment trends to identify systemic payer practices and broader recovery opportunities.
• Advise executive leadership regarding financial exposure, recovery opportunities, and legal risk.

Litigation & Dispute Resolution

You will lead or support litigation, arbitration, mediation, administrative proceedings, and other formal payer disputes. Responsibilities include developing litigation strategy, drafting or overseeing legal documents, directing outside counsel when specialized expertise is needed, participating in legal proceedings, negotiating settlements, and assessing the legal and financial merits of potential actions.

You will also work closely with Revenue Cycle to determine when complex or high-value denials should move beyond the traditional appeal process and be escalated as legal disputes.

Contract Enforcement & Revenue Protection

This position will help hold payers accountable to their contractual obligations by:

• Interpreting payer agreements and advising leadership regarding payment and enforcement rights.
• Identifying payer practices that may be inconsistent with negotiated contract terms.
• Supporting enforcement related to reimbursement, timely payment, audits, recoupments, and dispute resolution.
• Providing legal guidance during payer contract negotiations when reimbursement disputes or legal risks warrant involvement.
• Recommending contract changes that may help reduce future denials and underpayments.
• Developing strategies to reduce preventable revenue loss.
• Monitoring significant disputes and recovery efforts.
• Preparing executive-level reporting regarding litigation, financial exposure, and recovery opportunities.

What You'll Bring

Required Qualifications

• Juris Doctor (J.D.) from an accredited law school.
• Active license to practice law in Colorado or eligibility for admission, with Colorado admission required within six months of hire.
• Five or more years of legal experience, preferably including significant healthcare contracting experience.
• Experience negotiating complex commercial or healthcare agreements.
• Strong understanding of healthcare regulatory requirements.

Preferred Qualifications

• Experience working with a hospital, health system, academic medical center, or other healthcare organization.
• Payer contracting experience.
• Experience with physician arrangements and healthcare transactions.

The ideal candidate will also bring experience in healthcare and reimbursement law, payer disputes, litigation, denials and appeals, contract interpretation and enforcement, negotiation, regulatory compliance, financial and risk analysis, and executive-level communication.

Benefits

Community Hospital offers a comprehensive benefits package designed to support employees and their families. Benefits may include medical, dental, and vision coverage; retirement savings opportunities; paid time off; employer-paid and voluntary insurance options; wellness resources; and additional employee benefits and programs.

Benefit eligibility and individual plan provisions vary based on employment status and the terms of the applicable benefit plans.

Application Deadline

Applications will be accepted through November 30, 2026. The application period may be extended if the position has not been filled.

Join Community Hospital

If you are an experienced attorney who enjoys solving complex healthcare reimbursement challenges and wants to help shape a proactive approach to payer accountability and revenue protection, we invite you to explore this opportunity with Community Hospital in Grand Junction, Colorado.