No Fault/Liens Paralegal

CitiMed; New York (NY); On-site; USD 60,000 - 90,000; Full time

Job summary

CitiMed is actively seeking a No-Fault/Liens Paralegal to independently evaluate, investigate, and resolve assigned claims in line with statutes and company guidelines.

Reporting to the No Fault A/R Manager, you will liaise with clients, medical professionals, attorneys, and insurers to achieve favorable outcomes while ensuring compliant billing practices.

Qualifications

• Minimum 2–5 years of No-Fault billing experience.
• Preferred Paralegal or any other No-Fault legal experience.
• Understanding of No-Fault regulations in NY.
• Knowledge of HIPAA guidelines and compliance.

Responsibilities

• Review EOBs and No-Fault/Liens terms to identify issues.
• Identify insurance coverage eligibility via claims documentation.
• Resolve issues by coordinating with departments to correct bills/records.
• Contact patients, treating offices, and attorneys to resolve claims.
• Submit declaratory actions to arbitrating attorneys for filings.
• Reconcile account balances and verify payments on claims.
• Determine arbitration eligibility and adjudicate accordingly.
• Coordinate with arbitration attorneys for supplemental documents.
• Escalate unresolved inquiries to supervisors and contact adjusters by phone.
• Maintain communication with No-Fault/Liens and Verification Departments.
• Stay updated on NY jurisdictional requirements and related case law.

Skills

Fast learner

Microsoft Excel

Detail-oriented

Independent work

Analytical problem solving

Verbal and written communication

Adaptability

Under pressure

Education

Paralegal certification

Bachelor’s degree preferred

Tools

No-Fault billing software

Job description

CitiMed is a unique medical facility that provides exclusive healthcare amenities to our community. The range of medical and rehabilitative services offered has been specifically selected to treat traumatic injury patients. We provide a variety of health services including diagnostic and rehabilitation. Our vision directs the evolution of our practice, as we strive to improve our services to the community. All CitiMed offices are multilingual and staffed with individuals to make any experience pleasant. You can learn more about us at https://www.citimedny.com/.

CitiMed is growing rapidly and we are looking for many qualifying individuals to be a part of our team! With the support and hard work of all our employees, CitiMed continues to make its way down a successful road. CitiMed maintains a work culture that allows our team members to feel supported and confident in their work. We offer many learning opportunities with room for professional growth. If the responsibilities interest you and believe you have met the requirements, we strongly encourage you to apply!

About the Role

The No Fault/Liens Paralegal is responsible for the independent, prompt, and efficient evaluation, investigation, and resolution of assigned claims in accordance with legal statutes, policy provisions, and company guidelines to achieve positive results. Through effective investigation, coordination of medical care, negotiation, and interaction with clients, claimants, medical professionals, attorneys, and insurers ensure that the most advantageous outcomes are achieved, and client resources are utilized in a cost-effective manner. This position also provides technical expertise and serves as an advocate on client claim issues. Reporting to the No Fault A/R Manager, this position will be a key leader in the success of CitiMed’s future.

Responsibilities

Effectively and accurately identify, analyze, and bring to RESOLUTION of case issues by :

• Reviewing and understanding EOBs, their related terms pertaining to No Fault and Liens.
• Identifying insurance coverage eligibility through examination of claims documentation and related records.
• Resolving issues by collaborating with other departments to have bills and/or records corrected to prepare submission packets.
• If needed, contacting patients, treating offices, and attorneys to resolve claims.
• Reviewing and submitting declaratory actions from court in order to submit to arbitrating attorneys for legal filings.
• Consistently reconcile account balances and verify payments to ensure proper payment applications on claims.
• Review cases to determine arbitration eligibility. Adjudicate the claim effectively if arbitration is eligible based on department process guidelines.
• Coordinate with CitiMed arbitration attorneys for supplemental arbitration documents.
• Do not resort to only email communications with the necessary contacts if you are not successful in getting reimbursed, escalate your inquiry to a supervisor, contact the claim adjusters via the telephone and address the issue.
• Maintain a proper system of communication with the No Fault/Liens Claim Department & Verification Department, inform them about any cases you encounter that might require any update for billing purposes.
• Always maintain proper communication with the No Fault AR Manager to address any arising issues that you might not be able to resolve on your own.
• Maintain current knowledge of New York jurisdictional requirements and applicable case law.
• Maintain constant communication and if applicable, identify training areas with global resources to improve efficiency and accuracy.

Qualifications

• Minimum 2-5 years of No-Fault billing experience
• Preferred Paralegal or any other No Fault legal experience
• Understanding of No-Fault regulations in NY
• Knowledge of HIPAA guidelines and compliance

Required Skills

• A Fast learner
• Experience with Microsoft Excel
• Detailed Oriented
• Work independently and efficiently
• Analyze and problem solve independently
• Has superb verbal and written communication skills
• Flexible and can adjust to different situations
• Work under pressure to meet productivity guidelines

Equal Opportunity Statement

We are committed to diversity and inclusivity.