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Job Description
1. Minimum Candidate Qualifications:
a. Paralegal Certificate; and
b. Eligible to work in New York State
2. Job Description and Required Services:
Evaluate External Appeal applications for eligibility based on requirements in Insurance Law Article 49. Request necessary information from appropriate party and respond to questions about the process. Investigate complaints against regulated insurance companies, applying mandates in Insurance Law and provisions in the approved policy. Request necessary information from appropriate party and communicate findings when the investigation is complete.
DFS will train the paralegal on the internal process and applicable Laws, applicants must have excellent written and verbal communication skills.
Perform related duties as required:
· Screen requests for External Appeals in accordance with the Federal No Surprise Act.
· Screen requests for External Appeal in accordance with Insurance Law, Regulation, and the established protocols.
· Act as liaison using written and verbal communication for administrative processes with consumers and representatives of financial entities.
· Keep electronic case files updated, complete and organized.
· Research, process, and resolve consumer and provider complaints.
In addition, the candidate must possess and/or have the ability to:
a. Work individually and as part of a team.
b. Excellent verbal communication, writing, and interpersonal skills.
c. Ability to understand legal mandates.
d. Strong project management skills, including experience managing multiple time-sensitive, complex files simultaneously.
e. Detail-oriented with the ability to organize and prioritize tasks effectively in a fast-paced environment.
f. Proficiency with Microsoft Office, including working experience with Outlook, Word, Excel and Teams.
g. Reliability, and time and attendance are critical.
