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Years of Experience
Date Last Verified
Paralegal The candidate will be responsible for coordinating claim payments among health plan and responsible party through negotiating for successful recovery of 1st and 3rd party funds. Will work all aspects of the recovery process following client specific procedures and guidelines. Identify and develop subrogation recovery/settlement opportunities. Research and request case information to develop cases. Place parties of interest on notice of lien. Maintain a calendar diary to monitor case activity. Respond timely to all electronic, written and verbal communications. Required to maintain detailed and accurate records. Access and pull benefits from clientsâ€™ remote health claim systems. Pursue workerâ€™s compensation, third party liability, first party uninsured and underinsured recovery, workerâ€™s compensation, med-pay coverage and no-fault recoveries. Engage advice and/or help of legal manager to proactively resolve cases. Ensure compliance of state and federal laws. Adhere to settlement authority levels (through client specifics and/or policy and procedures). Negotiate health plan medical claim settlements in the best interest of the clients and firm Health Partners. Maintain department productivity and quality standards. Provide feedback to management on trends or developments. Sensitivity to privacy in accordance with HIPAA guidelines. Comply with HIPAA Compliance and Security Policies and Procedures.
Qualification and Experience
The candidate should have a Bachelorâ€™s Degree. Paralegal Certificate preferred. At least 2 years of experience in a legal environment. Should have an interest in the health insurance/personal injury fields. Working knowledge of Microsoft Word, Excel, internet research skills. Understand basic health plan contractual provisions and apply to reimbursement efforts. Must be confident on the phone and comfortable interacting with attorneys. Must be extremely detailed oriented and able to communicate with involved parties at all different aspects of the subrogation recovery process. Proven negotiation skills. Developed customer service skills. Strong organizational and time management skills. Ability to work independently and as part of a team.
Tracking Code: 519-124.
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