Lien Representative

Albert & Mackenzie is a well-established and expanding workers’ compensation defense law firm with a strong presence across California. Proudly recognized as a Great Place to Work for six consecutive years (2021–2026), the firm has also earned multiple Best Places to Work awards. As a Lien Representative, you will be responsible for the timely and accurate resolution of Workers’ Compensation lien claims on behalf of our clients. This includes reviewing medical and non-medical billing, assessing exposure, preparing files for negotiation or litigation, and ensuring compliance with applicable California Workers’ Compensation regulations and billing guidelines. Your work plays a vital role in reducing liability and supporting effective case resolution strategies. Key Responsibilities Include but Are Not Limited To: 1. File Review & Resolution Preparation - Review and analyze lien claims to assess validity, billing practices, and exposure. - Compare billed services to accepted body parts and treatment authorization; flag issues related to duplication, over-utilization, and unsupported charges. - Audit bills in line with the Official Medical Fee Schedule (OMFS), MTUS guidelines, and the DIR Drug Formulary. - Identify inappropriate billing (e.g., unbundled CPT codes, incorrect fee schedule application, overpricing, or off-formulary medications). - Research and document billing disputes to support negotiation or litigation. - Prepare case summaries, authority requests, and recommendations for resolution. - Organize findings in a manner that allows litigation or hearing representatives to proceed confidently with hearings if needed. 2. Discovery & Exhibit Preparation - Assist in the preparation and e-filing of Discovery and Trial Exhibits, including the use of internal templates to ensure compliance with WCAB requirements. - Verify that documents are properly served and admissible. - Support Hearing Representatives with pre-trial documentation. 3. Negotiations & WCAB Appearances - Negotiate settlements with lien claimants (e.g., interpreters, chiropractors, imaging centers) via phone or email. - Under guidance, participate in lower-complexity WCAB lien appearances or OTOCs. - Apply legal, medical, and technical knowledge to drive down settlement values. 4. Billing - Responsible for billing 8–10 hours per day, in accordance with established billing guidelines. - Ensure that time is logged accurately and that all billed activity reflects productive, client-facing work. - Any exceptions or non-billable tasks must be discussed with management in advance. - Billing compliance is a key performance metric and will be regularly reviewed by leadership. 5. Case Management & Reporting - Maintain accurate, detailed notes in the case management system. - Update internal databases and trackers regularly. - Submit timely, professional reports following established templates and protocols. - Proficiency in systems such as A1, ProLaw, Merus, or PerfectLaw is highly preferred. 6. Special Projects - Participate in special assignments such as bulk settlements, client audits, or file closure projects. - Assist with intake or file audits as needed. Work Environment: - Regular business hours (M–F typically 8:30-5pm). - Primarily remote; occasional travel to WCAB locations may be required. - Must be able to lift up to 15 lbs for file transport during in-person events or special projects. Qualifications: - 1–3+ years of experience in lien defense within Workers’ Compensation (defense firm experience strongly preferred). - Solid understanding of California WCAB procedures, OMFS, MTUS, and EAMS. - Strong organizational and time management skills. - Excellent communication (written and verbal) and negotiation abilities. - Familiarity with medical billing codes, provider profiling, and treatment authorization processes. - Paralegal certificate or equivalent legal education/training is a plus. Performance Expectations: - Meet or exceed daily billing goals. - Demonstrate accuracy and professionalism in all reporting and file handling. - Communicate clearly and effectively with clients and opposing parties. - Represent the firm professionally in all negotiations and WCAB interactions. - Comply with company policies and procedures at all times. Albert & Mackenzie ensures equal opportunity for all applicants regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other legally protected characteristics. Full-time employees receive a competitive compensation package that features discretionary bonus opportunities and a comprehensive benefits program, including medical, vision, short-term and long-term disability, life insurance, a 401(k) retirement plan, paid time off, and optional dental coverage. Notice of E-Verify Participation Notice of Right to Work Originally posted on Himalayas