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Tyson & Mendes LLP — San Diego
Who We're Looking For… We're looking for a billing compliance professional who has been in the weeds; someone who has audited timekeeper entries line by line, pushed back on attorneys when entries didn't hold up, and written appeals that resulted in successful resolutions. You know your UTBMS codes. You know when a narrative is going to get cut before it ever reaches the carrier.
And when the billing guidelines don't have a clear answer, you make a sound judgment call, in alignment with the spirit of carrier guidelines, and own it. This is a high-volume role with real variety, steady audit work, alongside special projects that require you to shift gears quickly, reprioritize, and perform at a high level under pressure. You'll work within a collaborative, fully remote team that communicates directly, respects each other's expertise, and expects everyone to bring their best.
If you've spent years building expertise in this niche and you're looking for a team that actually values it, this is for you. This position reports to the Director of Quality Assurance and the Head of Legal Operations, and collaborates closely with the Billing Department. This is a fully remote position.
Our entire team works 100% remotely, and we are built to operate that way with strong communication, clear expectations, and mutual accountability. For candidates located near one of our office locations, optional hybrid arrangements are available but never required. The right candidate is someone who takes ownership, communicates proactively, and thrives with autonomy.
Responsibilities
Conduct front-end pre-bill audits for insurance defense matters before invoices are submitted to carriers Perform line-by-line invoice review to verify accuracy, reasonableness, and compliance with carrier billing guidelines and UTBMS task codes Identify billing discrepancies based on carrier
Requirements
, industry standards, and litigation practices and make corrections before submission Communicate directly with attorneys, paralegals, and billing staff to resolve non-compliant entries, including navigating pushback with professionalism and persistence Prepare, submit, and track formal billing appeals; coordinate with the billing department to adjust invoices following appeal outcomes Build and analyze compliance reports in Excel to identify timekeeper performance trends and systemic billing issues Escalate recurring billing trends or compliance risks to management for resolution Manage the Billing Compliance inbox, triaging and prioritizing incoming requests Contribute to special projects including large-scale compliance initiatives and carrier-specific audit reviews as assigned Exercise sound independent judgment when billing guidelines are ambiguous or silent, acting in alignment with the spirit of carrier guidelines, and communicate your rationale clearly
, CounselLink, Bottomline, Legal Tracker) supporting insurance defense billing compliance, timekeeping oversight, or litigation defense matters Proven ability to audit billable hours for attorneys, paralegals, and other timekeepers prior to carrier submission Strong knowledge of UTBMS task codes, carrier billing rules, and common rejection reasons Demonstrated experience preparing and submitting successful billing appeals including strong written communication skills and the ability to construct persuasive, well-documented appeal narratives Advanced proficiency in Microsoft Excel, including pivot tables, formulas, and building custom reports to identify trends and support audit findings.