Associate Counsel – Digital Health, Contracting, Credentialing
Solera, Inc.
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteJob Level
JuniorMid-Level
About the role
- Draft, review, and negotiate commercial agreements including MSAs, SOWs, NDAs, BAAs, payor contracts, provider agreements, billing service agreements, and credentialing contracts.
- Structure and negotiate digital health partnership agreements and provider network relationships.
- Lead high-volume contract review for provider onboarding and network expansion.
- Develop and maintain contract templates for payor, provider, and digital health partnerships.
- Manage delegated credentialing agreements and contracting frameworks with health plans.
- Support amendments, contract performance monitoring, and value-based care arrangements.
- Build strong relationships with payor legal teams, digital health partners, and stakeholders.
- Provide legal counsel on billing and claims processing requirements, including 837 filing, CMS regulations, and reimbursement structures.
- Review and optimize billing policies, procedures, and operational compliance.
- Support billing dispute resolution, claim denials, and payor audit responses.
- Advise on provider enrollment, NPI taxonomy, CAQH processes, and billing eligibility.
- Support delegated credentialing program oversight and provider verification standards.
- Provide legal review for new billing processes and payor requirements.
- Maintain monitoring systems for regulatory changes related to billing, credentialing, digital health, and payor requirements.
- Conduct legal research on federal/state billing regulations, provider licensing, and digital health rules.
- Prepare legal memoranda and impact analyses for evolving regulatory requirements.
- Monitor payor policy changes affecting provider networks, credentialing, and digital health operations.
- Support corporate compliance initiatives and risk mitigation strategies.
Requirements
- Juris Doctor (JD) from an accredited law school.
- Active bar license in good standing.
- 3–7 years of relevant healthcare legal experience, ideally in digital health, payor operations, health technology, or billing/credentialing regulatory work.
- Strong expertise in healthcare billing, claims processing, and regulatory compliance.
- Demonstrated success negotiating payor and digital health provider contracts.
- Experience with NPI taxonomy, CAQH, provider enrollment, and credentialing requirements.
- Familiarity with delegated credentialing frameworks and verification processes.
- Deep understanding of CMS billing regulations and Medicare/Medicaid reimbursement rules.
- Proven ability to manage high-volume contract workflows.
- Strong research, analytical, and communication skills.
- Comfortable working cross-functionally with operations, billing, product, and network teams.
Benefits
- Remote-first culture
- Competitive compensation
- Unlimited PTO
- Medical, dental & vision insurance
- 401(k) with company match
- Professional development and certifications
- Wellness programs
- Company-sponsored training opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
contract negotiationcommercial agreementsbilling policiesclaims processingregulatory compliancecredentialinglegal researchcontract performance monitoringprovider enrollmentdigital health regulations
Soft skills
strong communication skillsanalytical skillsrelationship buildingcross-functional collaborationleadershiporganizational skillsproblem-solvingnegotiation skillsattention to detailrisk mitigation
Certifications
Juris Doctor (JD)active bar license