The Legal Consultant serves as a consultant providing advice to all three Sections of RCS related to legal and regulatory compliance issues and disputes. The Legal Consultant is responsible for assisting in providing advice to RCS colleagues and Mayo Clinic's Revenue Cycle and Contracting and Payer Relations Departments related to billing, reimbursement, consumer protection and collection issues. The work includes managing, coordinating, monitoring, and completing various projects within the Legal Recovery Services and Legal Risk Services Sections of RCS. This position serves as an expert and consultant on various legal, compliance and insurance issues. This position includes regular and on-going communications with staff at all levels within the organization, parties external to Mayo with respect to billing, reimbursement, collection, litigation and insurance matters. In addition to presenting at site visits and internal conferences and seminars, this position also acts as a client liaison between RCS and its clients. Responsible for investigating, coordinating, managing and resolving legal and insurance cases and contracts in RCS, as well as, assisting and offering guidance to the Legal Representative, and Recovery Analyst positions on case management and settlement decisions. The Legal Consultant may also be responsible for advising the RCS Claims Section staff and managing general liability claims as well as the RCS Legal, Disability and Absence Management Section related to absence and disability related issues including the ADA, FMLA and paid leave laws. The Legal Consultant is responsible for appearing at mediations and Administrative Court proceedings, such as hearings, pre-trials, and settlement conferences representing the interests of Mayo and its affiliates. Works independently in the management of high dollar and complex cases, which includes independent decision making; performing legal research analysis, interpretation, and communication of complex federal and state laws and regulations; drafting pleadings; working collegially with staff attorneys as appropriate; and monitoring and participating in the litigation and settlement negotiating process to ensure a favorable settlement for Mayo entities, per Mayo settlement guidelines. Must keep abreast of matters of law pertaining to RCS business in order to properly manage caseload and provide educational information to Mayo entities. Acts as an expert resource for billing, insurance, settlement, legal documents, and compliance questions from colleagues and clients.

This vacancy is not eligible for sponsorship/ we will not sponsor or transfer visas for this position.

This position is primarily remote. However, this individual must live within driving distance to the Mayo Clinic Rochester campus.  

Any candidate must possess a bachelor’s degree and a paralegal degree from an American Bar Association certified program, which may be part of the bachelor's degree. In addition, this candidate must have successfully completed PACE (Paralegal Advanced Competency Exam), other professional designation, or a master’s degree in business or insurance. Previous experience of 7 years as a Legal Representative, Paralegal, and/or Recovery Analyst required. A Juris Doctorate (JD) degree and 7 years of Legal experience may be substituted for all of the aforementioned qualifications.The ability to understand federal and state laws in workers’ compensation, subrogation, probate, bankruptcy, civil litigation, healthcare, ERISA, HIPAA, COBRA, and/or insurance and to continue a course of study is necessary. Ability to efficiently manage a variety of complex cases and projects simultaneously in difficult and challenging situations. Requires strong decision-making capabilities and independent judgment, including the management of confidential information, sensitive situations, conflict resolution, and negotiation skills. It is expected that a knowledge of insurance practices, terminology, and medical coding procedures (ICD, CPT, UB, HCFA) is established. Qualified persons must be familiar with employer benefits plans. Computer experience with Microsoft Word, Excel, Power Point, and the ability to gain an understanding of any additional systems is required. Any candidate will also possess proven experience in project management, independent work direction, and peer and/or client training.National Federation Paralegal Association (PACE) Certification; National Association of Legal Assistants (NALA) Certification, or master's degree.