Legal Review Specialist - Part-time
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Overview
Schedule
Part-time
Career level
Senior-level
Remote
Remote
Compensation
$58-$63/hour
Job Description
This position is contingent upon the successful award of the associated contract. Employment is not guaranteed until the contract is awarded, and the position is officially activated. Job responsibilities and requirements are subject to change.Position: Legal Review SpecialistLocation: Remote Status: Part-timeAbout J29J29 is an employee centered healthcare management consulting company that specializes in processing, reviewing, and analyzing medical claims, records, disputes, and audits. Established in 2017, J29 prides itself on its employee centric culture and high employee retention rates that allow us to ensure that we are creating a working environment that prioritizes the employee experience. Our team brings corporate performance that stretches to various areas where we can provide our clinical, healthcare policy, and compliance expertise through our support to health and human service programs at the State, Federal, and Commercial levels. OverviewJ29 is seeking a Legal Review Specialist to provide regulatory and legal analysis in support of federally funded healthcare programs and Medicare appeals operations. This role is responsible for reviewing appeal determinations, evaluating supporting documentation for legal and regulatory sufficiency, interpreting Medicare statutes and regulations, and providing guidance on complex policy and adjudicatory matters.The Legal Review Specialist serves as a key resource in ensuring that appeal determinations and related review materials are accurate, defensible, and consistent with applicable federal laws, regulations, and agency guidance. The ideal candidate possesses extensive knowledge of Medicare regulations and appeals processes, strong analytical and writing skills, and experience supporting healthcare compliance, program integrity, or government healthcare initiatives.Role & Responsibilities
- Review appeal determinations, case files, and supporting materials for legal and regulatory sufficiency.
- Analyze complex Medicare policy, statutory, and regulatory issues related to appeals and coverage determinations.
- Advise internal stakeholders on the interpretation and application of Medicare statutes, federal regulations, agency guidance, and sub-regulatory materials.
- Support responses to government inquiries and requests involving regulatory, legal, or policy-related matters.
- Assist in the preparation of materials for administrative hearings, adjudicatory reviews, and higher-level appeal proceedings.
- Conduct legal and regulatory research to support appeal determinations and program operations.
- Evaluate case documentation and determination rationales to ensure consistency with applicable legal and regulatory requirements.
- Identify regulatory risks, compliance concerns, and policy implications associated with appeal outcomes.
- Draft and review legal memoranda, policy analyses, issue papers, and written recommendations.
- Collaborate with clinical reviewers, appeals analysts, operational staff, and leadership to address complex regulatory and case-specific issues.
- Support quality assurance, audit readiness, and compliance review activities.
- Monitor changes in Medicare regulations, agency guidance, and adjudicatory requirements and communicate impacts to stakeholders.
- Assist in the development and maintenance of policies, procedures, and operational guidance.
- Juris Doctor (JD) from an accredited law school preferred; equivalent legal, regulatory, or healthcare policy experience may be considered or Bachelor's degree required.
- Seven (7) or more years of experience supporting Medicare, healthcare regulatory compliance, appeals, program integrity, policy analysis, or federal healthcare programs.
- Experience with Medicare statutes, CFR interpretation, or CMS adjudicatory processes
- Experience supporting CMS, OGC, or federal healthcare programs preferred
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FAQs About Legal Review Specialist - Part-time Jobs at J29, Inc
What is the work location for this position at J29, Inc?
This job at J29, Inc is located in Millersville, MD, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.
What pay range can candidates expect for this role at J29, Inc?
Candidates can expect a pay range of $58–$63 per hour for this role.
What employment applies to this position at J29, Inc?
J29, Inc lists this role as a Part-time position.
What experience level is required for this role at J29, Inc?
J29, Inc is looking for a candidate with "Senior-level" experience level.
Does J29, Inc allow remote work for this role?
Yes, this position at J29, Inc supports remote work, giving candidates the flexibility to work outside the primary office location.
What is the process to apply for this position at J29, Inc?
You can apply for this role at J29, Inc either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.