US Anesthesia Partners is the highest-quality single-specialty anesthesia practice in the United States, with over 6,000 employees distributed across 12 states. Our clinical and non-clinical staff support each other as they work toward a common vision: Empowering people to advance exceptional care. 

POSITION SUMMARY: This position provides advice and counsel in all areas surrounding certain out-of-network issues and payor contracting. This position is also responsible for providing legal counsel and guidance to the Company’s executives, professionals and other employees relating to the Company’s business activities.

ESSENTIAL DUTIES AND RESPONSIBILITIES: (The ideal candidate must be able to complete all physical requirements of the job with or without a reasonable accommodation)

Out-of-Network Payment Disputes

• Advises internal stakeholders on No Surprises Act (NSA) compliance and Independent Dispute Resolution (IDR) processes.
• Provides legal support for resolving underpayments, denials, and delays from payors for out-of-network claims in IDR processes.
• Reviews facts, such as ERISA plans, assignment of benefits, and claim adjudication histories, to support IDR efforts.
• Drafts and reviews offer briefs, appeal documents, and assists in preparing materials for IDR, arbitration, or litigation when necessary.

Contracting and Revenue Cycle Management

• Drafts, reviews, and negotiates in-network contracts with commercial health insurers, managed care organizations (MCOs), and third-party administrators (TPAs).
• Analyzes contract language for reimbursement terms, rate schedules, termination provisions, dispute resolution mechanisms, and compliance with federal and state laws.
• Partners with Revenue Cycle, Contracting, and Finance teams to support reimbursement strategy and evaluate contract performance.
• Maintains contract templates and assists in contract lifecycle management.

General Legal Support

• Monitors developments in federal and state healthcare regulations affecting provider reimbursement.
• Assists with internal training on legal and regulatory requirements related to IDR processes, contracting, and reimbursement.
• Supports other legal and business initiatives as needed, under the supervision of Senior Counsel.

KNOWLEDGE/SKILLS/ABILITIES (KSAs):

• Juris Doctorate (JD) from ABA accredited university, membership in good standing of State Bar.
• 3-4 years legal experience with an emphasis in healthcare-based contract law and litigation.
• Excellent organization, prioritization and multitasking skills, practical and effective problem-solving skills, strong analytical, negotiation, and communication skills, and the ability to exercise sound judgment, commercially focused legal advice and appropriately consider risks to the Company.
• Exceptional attention to detail is critical for this role.
• Candidate must be able to interact effectively and collaboratively with the Company’s executives, professionals and other employees, as well as with in-legal colleagues and outside counsel.
• Work well independently and within a team environment, both in person and virtually.
• Well-developed level of business experience supporting clients or advising on specialty law matters.
• Experience with healthcare laws and regulations, preferred.

*The physical demands described here are representative of those that may need to be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

• Occasional Standing

• Occasional Walking

• Frequent Sitting

• Frequent hand, finger movement

• Use office equipment (in office or remote)

• Communicate verbally and in writing