Paralegal - Medicare

SUMMARY: 

This position will provide legal assistance to the attorneys representing the Enterprise in all aspects of legal case preparation and file management including legal research; analyzing law sources such as statutes, judicial decisions, legal articles and legal codes; drafting complex documents; contacting and interviewing clients, attorneys and witnesses; and collecting documents and information relevant to cases. The position requires you to perform expected tasks with minimal supervision.

RESPONSIBILITIES/TASKS: 

• Review and summarize medical and other records and prepare summaries of relevant information.
• Interview witnesses to gather information or confer with personnel in other departments and outside the organization while performing research or other legal responsibilities.
• Assist attorneys with complex caseload research, subject and topic research, and briefings of court cases.
• Provide advice and guidance on a variety of activities and contracts.  Identify complex legal or business issues.
• Assist attorneys with complex and/or sensitive hearings by preparing notes, organizing, assembling and filing exhibits.
• Draft settlement documents and other pleadings, as directed.
• Perform other legal tasks, as jurisdictionally permitted.
• Perform special assignments as requested by the attorneys.
• Retrieve and analyze information from the Workers' Compensation website.
• Assist in preparation of worker’s compensation files for hearing.
• Assist Manager with docket management and case assignment

MEDICARE SPECIFIC TASKS:

• Manage MSAs through the Center for Medicare & Medicaid Services (CMS) submission and approval process, including obtaining and organizing records, ensuring material submitted satisfies CMS submission requirements, and working with the attorneys on development requests.
• Oversee and assist with completion of settlement-related documents, including annuity and professional administration paperwork.
• Review complex files, as assigned, to determine the appropriate data to report to CMS for Sec. 111 purposes. 
• Facilitate conditional payment dispute and resolution as directed by attorney.
• Perform special assignments as requested by the Medicare attorneys.
• Retrieve and analyze information from CMS, vendors, and Workers' Compensation websites.
• Facilitate preparation of worker’s compensation files for MSA drafting and CMS submission as directed by attorney.

This position description identifies the responsibilities and tasks typically associated with the performance of the position.  Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS:

EDUCATION OR EQUIVALENT EXPERIENCE:

Bachelor’s degree in paralegal studies or Paralegal certification required. Continuous learning, as defined by AF Group’s learning philosophy, is required. Certified Medicare Secondary Payer (CMSP) certification is required within one (1) year from the date of hire. Certification or progress toward certification in workers’ compensation, Medicare Set-Aside Consultant Certified (MSCC) is preferred and encouraged. A combination of relevant education and experience may be considered in lieu of a degree. 

EXPERIENCE: 

Two to four years of paralegal experience involving Medicare Secondary Payer compliance work and Medicare Set-Aside submission to CMS, liability or workers compensation cases preferred. Prior experience with workers’ compensation and liability claims is preferable but not essential. 

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

• Broad knowledge of the principles of the judicial and administrative process. 
• Legal knowledge of research procedures and use of a Law Library.
• Strong oral/written communication, interpersonal and customer service skills are essential. 
• Ability to work on own initiative, multitask and meet deadlines. 
• Ability to handle confidential information sensitively and discreetly.
• Proficient in Microsoft Windows including spreadsheet applications and Microsoft Word.
• Strong organization, multi-tasking and attention to detail skills required.
• Strong analytical and problem-solving skills required.
• Ability to work independently as well as within a team.

WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards. Minimal travel required.         

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description. 

 PAY RANGE: 

“Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $48,900 and $81,900.”

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis.  Nothing herein is intended to create a contract.

#LI-CH1

#AFG