Independent Dispute Resolution Paralegal

Dane Street; West Palm Beach (FL); Remote; USD 45,000 - 70,000; Full time

Job summary

An established industry player is seeking motivated paralegals to join their innovative dispute resolution program. This role involves reviewing medical billing information and ensuring accuracy in documentation, all while adhering to client deadlines. As part of a fast-paced environment, you will collaborate with other professionals, enhancing your skills in a supportive setting. With a focus on quality assurance, you will play a crucial role in the claims management process, contributing to the success of the organization. If you are driven, detail-oriented, and ready to make an impact, this opportunity is perfect for you.

Benefits

Generous paid time off

Excellent benefits package

Competitive salary

Qualifications

• 3-5 years of paralegal experience in law firms or healthcare.
• Strong written and verbal communication skills are essential.
• Ability to work under pressure and meet tight deadlines.

Responsibilities

• Evaluate medical information for proper case adjudication.
• Ensure accurate matching of medical records to documentation.
• Provide excellent customer service and quality assurance.

Skills

Organizational skills

Attention to detail

Written communication

Verbal communication

Ability to meet deadlines

Self-motivation

Education

3-5 years of experience as a paralegal

Healthcare organization experience

Arbitration experience

Tools

Google Chrome

Gmail

Google Docs

Google Sheets

Job description

Paralegals, claims resolution managers, and administrative law judges with healthcare claims experience are needed!

Dane Street is looking for highly motivated paralegals to work in a new dispute resolution program. Pre-legal, professional bill review, claims resolution managers, and administrative law judges all have the skills necessary for this program. Dane Street offers an exciting work environment, competitive compensation, and strong growth potential.

Job Summary:

A new program on the group health side of our business allows you to apply your organizational knowledge to review reports accompanying medical records, ensuring that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information, address all questions posed, and ensure reports are returned within client deadlines.

Core Duties & Responsibilities:

1. Evaluate and organize medical information to ensure proper case adjudication, determining whether they meet all established program standards.
2. Ensure that medical records are matched appropriately to documentation; obtain correct documentation if mismatched.
3. Participate in training, including arbitration training if applicable.
4. Read policy guidelines to determine when criteria are met or not met.
5. Evaluate claims for conflicts of interest and appropriateness.
6. Work within established timeframes set by program parameters.
7. Provide excellent customer service, working closely with clients on a case-by-case basis to deliver complete, timely, and error-free quality assurance.
8. Oversee complex cases requiring additional review before returning to the client.
9. Serve as an additional level of QA and clinical review for cases with quality issues.

Requirements

Required Education & Experience:

• 3-5 years of experience as a paralegal in a law firm, healthcare organization, 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.
• Background in medical office or healthcare is a plus.

Required Skills:

• Ability to work with a sense of urgency and meet deadlines.
• Self-motivated with a strong drive for performance excellence.
• Excellent written and verbal communication skills.
• Proficiency in navigating various computer programs (experience with Google Chrome, Gmail, Docs, Sheets, etc., is a plus).
• Attention to detail is mandatory.

Important Notice: Dane Street will never conduct interviews via text or request checks for equipment purchases to ensure security.

About Dane Street:

As a fast-paced Inc. 500 company with a high-performance culture, Dane Street processes over 200,000 insurance claims annually for leading national and regional carriers, third-party administrators, managed care organizations, employers, and pharmacy benefit managers. We offer customized IME and peer review programs to assist clients in accurate medical determinations within the claims management process.

Benefits

We provide generous paid time off, an excellent benefits package, and a competitive salary. If you thrive in a fast-paced environment and want to make a meaningful impact, we encourage you to apply.