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Lien Negotiator / Hearing Representative (Workers' Compensation)

California - Remote

About AM Lien Solutions

AM Lien Solutions is the leading California provider of lien resolution services. We offer a broad range of services including Lien and Litigation Management, Defense of 5811 Petitions, Specialized Bill Review, Medical Legal Dispute Resolution, Walk Through Lien Services, Medical Legal Record Review Preparation, Provider Fraud and Abuse Detection, and Continuing Education (CEU Training and Seminars). We serve Insurance Carriers, Third Party Administrators, Private Employers, and Public Entities.

Job Description:

As a Lien Negotiator or Lien Hearing Representative at AM Lien Solutions, 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. 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.

3. 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.

4. 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.

5. 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.

6. Special Projects

  • Participate in special assignments, including bulk settlements, client audits, and file closure projects.
  • Assist with intake or file audits as needed.

Qualifications:

  • 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
  • Proficiency in systems such as A1, ProLaw, Merus, or PerfectLaw is highly preferred

Work Environment:

  • Regular business hours (Monday – Friday typically 8:30 am - 5:00 pm)
  • Primarily remote; occasional travel to WCAB locations may be required (in-office options available)
  • Must be able to lift up to 15 lbs for file transport during in-person events or special projects
  • Compensation:
    • Lien Specialist / Negotiator Salary: $75,000 - 85,000
    • Lien Hearing Representative: $75,000 - 110,000

Benefits:

  • Flexible work from home ability
  • Work/Life Balance
  • Generous Vacation Time
  • Casual attire at home and Court attire for Hearings
  • Employer-sponsored medical and Vision coverage for the employees
  • Employer-sponsored Life, ADD&D, Short Term Disability and Long-Term Disability
  • Voluntary dental and additional life coverage
  • Flexible Spending Plan to include Dependent Care and Health Care plans
  • Ancillary benefits such as Accident and Critical Illness offered
  • 401(k) plan with employer contribution

AM Lien Solutions is an equal opportunity employer. Applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.

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