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 Expectati