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Carrot Peelers, Sales, Personality and Your Job Search
In-House
Legal Staff
Health Care
Min 3 yrs required
Paralegal The candidate will support attorneys on the team in their preparation and trail of payment denial appeals. Act as a working supervisor performing paralegal functions in support of the ALJ appeals team. Supervise and assign workload to all paralegals (contract and otherwise) on the ALJ Appeals Team. Train new paralegal ALJ Team members on all ALJ team/pertinent company procedures. Draft, update and maintain ALJ Team Policy and Procedures manual (ALJ Team Desk Book). Function as the initial/primary contact with the SSCs, facilities and beneficiaries on behalf of the ALJ Team. Monitor and respond to all email inquiries directed to the ALJ Team mailbox. Secure attorney Appointment of Representative forms (AORs) from the facilities. Draft, prepare, review and process beneficiary letters re updates in the case. Calendar and secure conference rooms for hearings. Receive, review and log all pertinent incoming/outgoing ALJ mail (Abacus and Excel). Prepare, review and process USPS and FedEx outgoing mail. Implement and execute QC procedures for new ALJs and outgoing/incoming mail. Establish, organize and maintain new case pleadings and medical records. Review and analyze new denials for filing at the ALJ Level. Input of new ALJ Appeals into Abacus and calendar deadlines. Review, assign and monitor new appeals to ALJ attorneys. Work closely with SSCs and facilities to ensure accuracy and completeness of company data pertinent to the cases. Management of Abacus (case management software): Administrative responsibilities in Abacus; Input new data into ABACUS; Create and update ALJ Forms (pleadings, letters, reports). Review and analyze current Office of Medicare Hearing Appeals (OMHA) data; update Abacus. Perform quality control on data in Abacus (co-worker audit, deadline audit, reporting and corrections). Notify parties (SSCs, ALJ Attorneys, and Beneficiaries) of updates in the case. Maintain attorney calendars. Assist attorneys in hearing preparation, including but not limited to: file organization, Bates stamping, redacting, and general pre-hearing/hearing preparation. Secure hard copy of medical records as needed. Update and track all new ALJ filings; update Excel and Abacus databases. Draft and implement various reports for attorneys as needed. Prepare and review weekly/monthly Reports for SSCs/ALJ Team. 3+ years of experience is needed as a Paralegal and experience supervising others is preferred. Bachelor degree is preferred. Paralegal certificate required, however 3+ years of work experience as a paralegal, in addition to the three years required above can substitute for formal training. Paralegal certificate; working knowledge of Microsoft Office software, familiarity with Excel, ability to learn litigation management software and database, and strong attention to detail required.
Job Number: 10201-22246
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