Nurse consultant Jobs in Saint Paul, MN

Location: Hybrid - 8 days a month in the office on Mondays and Thursdays.

Basic Function

The Legal Invoice Review Quality Assurance Analyst (“QA Analyst”) for Wolters Kluwer, Fulfillment Center of Excellence will be responsible for performing the quality assurance testing for the Legal Bill Analysis Center of Excellence (LBACOE). The Legal Bill Analysis (“LBA”) process involves the prompt, accurate and efficient auditing of electronically submitted legal fee and expense invoices submitted by law firms and vendors of our clients.

As part of our quality assurance process, the QA Analyst will conduct an expert peer review of LBACOE invoice analysts’ work while independently utilizing his or her specialized legal expertise, knowledge base and education. After making a comprehensive, expert assessment of the legal context and terminology in the invoice, the QA Analyst will make additional adjustments to previously-adjusted invoice line item entries, if needed, and document the comprehensive justification for such adjustments. The QA Analyst will also make corrections to adjusted and non-adjusted invoice lines. Moreover, the QA Analyst, as part of our Appeals Team, will engage in written communications with the law firm vendors of our customers regarding the adjustments made to invoice line item entries by the LBACOE. The ultimate goal of QA Analyst communications with the law firms is to fully leverage the QA Analyst’s robust legal knowledge base and partake in legal expert-to-expert discourse so as to arrive at a reasonable, mutually-agreeable resolution on disputed invoice adjustments, subject to our customers’ ultimate directive(s). The QA Analyst will also be responsible for supporting the appeals mediation efforts of the LBACOE by extracting core legal concepts at the heart of the invoice, analyzing the full legal context of the invoice in line with our clients’ billing guidelines and memorializing the appeals expert-to-expert discourse, all of which is to be included in a written summary for review by our client(s) and/or for use at a resolution conference to be attended by the law firm, LBACOE and our client(s).

The QA Analyst will also provide guidance to business unit partners regarding issues or opportunities within the LBA process.

Essential Responsibilities

• Drive the results of the LBACOE quality assurance process, as follows:Conduct review of LBACOE Legal Invoice Analysts’ line item adjustments and non-adjusted invoice lines, applying specialized legal subject matter expert knowledge to context of legal invoice line items for quality assurance. Using sound individual discretion and with minimal supervision, conduct gap filling analysis to decode the legal “story” of an invoice by utilizing required law school education, law firm experience and/or related specialized legal expertise,Verify the compliance to legal billing guidelines by law firms and vendor submitting invoices.Verify the accuracy of the UTBMS task codes (Fee, Activity and Expense codes) applied to invoice line items.Independently make further adjustments to invoice line items as necessary based on his or her assessment of the legal context of the invoice while utilizing specialized his or her legal subject matter expert knowledge to extract core critical legal terminology and concepts. Document reasons for any additional adjustments made to invoice line items, identifying the billing guideline violated and the rationale for the amount adjusted.Use legal knowledge and careful discretion to make corrections to adjusted and non-adjusted invoice lines as needed.Forward the audited and peer-reviewed legal invoice through the review chain as required.
• Promptly and professionally resolve law firm appeals, as follows:Receive and organize law firm requests for reconsideration from Operations Support Specialists or management and/or work the intake queue for requests for reconsideration.Address law firm requests for reconsideration of adjusted amounts while utilizing careful judgment, legal knowledge and utmost professionalism while upholding integrity of the legal billing process.Work with law firms in a professional manner via legal expert-to-expert written communications to carefully resolve disputed adjusted invoice line items using sound independent discretion and vast legal knowledge base.Efficiently and accurately review appealed legal invoice entries.Excellent ability to review, analyze and evaluate legal fee and cost/expense in appealed invoice entries and to exercise discretion and sound independent judgment when making audit and adjustment decisions in a law firm appeals context.Gather key information regarding the adjustment history and the LBACOE communication history on a disputed line item.
• Additional Responsibilities and Skills:Support internal management in documenting performance metrics for internal use and use with clients and law firms.Communicate and calibrate with audit team and appeals team members as part of critical legal expert QA Analyst “task force” that resolves ambiguities or “close judgment calls” in interpretation of client guidelines when applied to complex legal invoicing scenarios. Strong understanding of legal terminology and claims legal situations, multijurisdictional exposure preferred.Using sound discretion and legal expertise, analyze and condense legal service agreements to produce effective operational outputs meeting and in some cases exceeding customer expectations.Self-motivated with an ability to work independently and with very limited supervision after training.Excellent computer skills with the ability to learn the electronic legal bill submission and auditing softwareSound command of the English language-- grammar, syntax and style -- including an understanding of the conventions of punctuation and capitalizationExcellent spelling and proofreading skillsEffective communication skills - ability to obtain information from others and deliver information to others orally and in written formOrganizational skills, including the ability to organize work in an orderly fashion conducive to the prompt, efficient review of an appropriate number of legal invoices in a given day or time periodFamiliarity with common business math and possess appropriate business telephone skillsAbility to carry out detailed written or verbal instructions; ability to respond to requests effectively and efficiently

Qualifications

Education and Licensure

Minimum: Bachelor’s Degree required. Juris Doctor degree from an ABA-accredited law school required.

Experience, Knowledge and Tools

Required Experience: 0-2 years of the following experience.

• Prior experience in a legal services or legal invoice auditing environment.
• Prior experience with direct communication with law firms in a legal billing context.
• Experience with handling conflict with law firms, in writing and telephonically.
• Highly developed communication skills, including both excellent written and verbal skills.
• Firm grasp of the Federal and/or State Rules of Civil Procedure.
• Insurance defense and civil litigation experience preferred.
• Prior legal invoice auditing experience either in-house or with a third party legal invoice auditing company strongly preferred.

Preferred Experience:

• Prior US and International legal invoice review and analysis experience in a legal invoice analyst role.
• Prior experience in auditing claims litigation.
• Prior work experience with an insurance company.
• Experience in handling appeals of legal invoice claims adjustments.
• Prior experience with direct communication with law firms in a legal invoice review context.
• Experience with handling conflict with law firms, in writing and telephonically.
• Highly developed communication skills, including both excellent written and verbal skills.

Required Competencies:

• Communications: Strong arbitration and organizational skills are critical to being successful in this role. Strong communications skills and the ability to organize and motivate team members in a matrix environment are essential.
• Team Work: Must work collaboratively with people within LBACOE and throughout the entire WK organization, while providing constructive feedback to LBACOE from the BUs.
• Problem Solving: Capable of independent thinking and rendering sound decisions. Astute at identifying and engaging the necessary resources to help in decision making. Takes quick actions to identify and resolve the cause of any problem. Proactive in nature.
• Leadership: Exhibits individual control over day to day responsibilities as well as the ability to work collaboratively with other BUs to produce results.
• Planning and Organizing: Must be able to implement plans with the purpose of achieving short and long term goals. Must be able to prioritize in order to accomplish these goals in a given time period.
• Technology: Has the ability to partner with experts in the technology field to identify technology gaps and requirements necessary to develop position and impactful solutions.
• Learning: Ability to acquire new or modify existing knowledge to support a changing market place and workforce. Can demonstrate a capability to learn by study, experience, or instruction.
• Initiative and Enterprise: Is self-directed and has the ability to translate ideas into action and get things done.

Tools:

• Microsoft Office Suite ( Word, Excel, PowerPoint, Outlook)

Travel requirements

• Ability to travel domestically in the US independently
• Ability to obtain a Citi Corporate Credit Card to cover company expenses.