Paralegal
June 29, 2023
Description
•Evaluates and organizes medical information to ensure that cases are adjudicated properly. The successful candidate will determine whether they meet all established program standards. •Ensures that the medical records are matched appropriately to documentation, and if not, obtains the correct documentation. •Participate in training for this position, some training may include arbitration training. •Read policy guidelines and delineate when criteria are/are not met. •Evaluates claims for conflict of interest and appropriateness. •Works within established timeframes set by program parameters. •Provides strong customer service skills and works closely with clients on a case-by-case basis to provide complete, timely, and error-free quality assurance of cases. •Provides oversight to cases that are complex and need additional review prior to return to the client. •Serves as an additional level of QA and clinical knowledge/review for cases with quality Issues.
Requirements
•3-5 experience as a paralegal in a law firm, health care firm or entity processing disputed claims. •Arbitration experience is strongly preferred. •Experience working remotely is preferred. •Experience with medical office or hospital claims services is preferred. •Medical office or health care background a plus.
Benefits
Benefits We offer generous Paid Time Off, an excellent benefits package, and a competitive salary. If you are an outstanding candidate for this position, if you thrive in a fast-paced environment, and if you are interested in doing meaningful work that impacts others' lives, then we encourage you to apply.
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