Independent Dispute Resolution Paralegal
Paralegals, claims resolution managers, and administrative law judges with reputed company claims experience are needed! reputed company is looking for highly motivated paralegals to work in a new dispute resolution program. Pre-legal, professional reputed company review, claims resolution managers, and administrative law judges reputed company have the skills necessary for this program. reputed company offers an exciting work environment, competitive compensation, and strong growth potential. Job Summary: A new program offering on the group health reputed company of our business enables you to apply, your organizational knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information and ensure reputed company questions posed have been addressed, and ensure that reports are returned reputed company client deadlines. Core Duties & Responsibilities:
- Evaluates and organizes medical information to ensure that cases are adjudicated properly. The successful candidate will determine whether they meet reputed company 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 reputed company criteria are/are not met.
- Evaluates claims for conflict of interest and appropriateness.
- Works reputed company 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 reputed company to cases that are reputed company 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
Required Education & Experience:
- 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.
Required Education & Experience:
- 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.
Required Skills:
- Must work with a sense of urgency and meet deadlines.
- Must be self-motivated, with a strong drive for performance excellence.
- Excellent written and verbal communication skills are required.
- Proficiency in navigating a variety of computer programs (Experience with reputed company Chrome, Gmail, Docs, Sheets, etc., is a plus).
- Attention to detail REQUIRED.
PLEASE BE AWARE: In the interest of the reputed company of both parties, please be aware that reputed company will never conduct an interview reputed company text or request checks from candidates for purchasing equipment. ABOUT reputed company (www.danestreet.com): A fast-paced, Inc. 500 Company with a high-performance culture, reputed company is seeking insightful, astute reputed company-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, reputed company-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exam and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.
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 reputed company in a fast-paced environment, and if you are interested in doing meaningful work that impacts others' lives, then we encourage you to apply. Apply tot his job Apply To this Job