Paralegal, Medicare Appeals (Remote)

Talent Advantage Partners; United States; Remote; USD 62,000 - 120,000; Full time

Job summary

An established industry player is seeking a detail-oriented Paralegal to support its work with healthcare regulations. This fully remote position offers a competitive salary and comprehensive benefits, including medical, dental, and vision coverage, alongside a 401(k) plan. The ideal candidate will have at least three years of experience in paralegal work, particularly in Medicare regulations. Join a collaborative team dedicated to ensuring fair and efficient hearings in healthcare administration, where your contributions will make a meaningful impact.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

401(k) Plan

Paid Time Off

Professional Growth Opportunities

Qualifications

• 3+ years of paralegal experience in healthcare regulatory compliance.
• Strong knowledge of Medicare regulations and legal document preparation.

Responsibilities

• Review and analyze appeal requests for completeness and jurisdiction.
• Draft legal memoranda and prepare notices for hearings.
• Maintain electronic case files in compliance with CMS requirements.

Skills

Healthcare Regulatory Compliance

Legal Document Preparation

Medicare Regulations

Analytical Skills

Legal Research

Attention to Detail

Organizational Skills

Writing Abilities

Education

Bachelor's Degree in Paralegal Studies

Tools

Salesforce

Office of Hearings Case and Document Management System

Job description

Our client is seeking a detail-oriented Paralegal with experience in healthcare regulations to support its work with the Centers for Medicare & Medicaid Services (CMS) Office of Hearings. This is an exciting opportunity to contribute to the administration of fair and independent Medicare RADV appeals in a collaborative, mission-driven environment. The ideal candidate will bring a minimum of three years of paralegal experience, preferably within healthcare regulatory compliance, with demonstrated expertise in Medicare regulations and legal document preparation.

About the Organization

Our client is a leading provider of specialized administrative and legal support services for healthcare organizations. Currently supporting CMS Office of Hearings, they focus on Risk Adjustment Data Validation (RADV) appeals processes, ensuring fair, accurate, and efficient hearings in support of healthcare providers nationwide.

Why Join the Team?

• Workplace Flexibility – !!Fully Remote, salaried position with a 37-hour work week!!
• Competitive Compensation – A salary package that reflects your experience and qualifications
• Comprehensive Benefits – Medical, dental, and vision coverage, alongside a 401(k) plan with profit sharing
• Paid Time Off – PTO, holidays, bereavement, and parental leave, plus resources focused on health and well-being
• Professional Growth – A collaborative, team-based work environment with opportunities for long-term career advancement

Key Responsibilities

• Review and analyze appeal requests and supporting documentation for completeness, timeliness, jurisdiction, and standing
• Identify and categorize motions, objections, and preliminary legal matters
• Process and track appeals throughout their lifecycle using the Office of Hearings Case and Document Management System (OH CDMS)
• Schedule and coordinate pre-hearing conferences and hearings (record, virtual, and in-person)
• Prepare notices, correspondence, and other required documentation
• Attend pre-hearing conferences and hearings to document proceedings
• Draft legal memoranda with analysis and recommendations for hearing officers
• Research and apply relevant regulations, particularly 42 CFR § 422.311
• Draft proposed decisions addressing appealed issues with appropriate legal citations
• Maintain electronic case files and documentation in compliance with CMS requirements
• Support development and refinement of Standard Operating Procedures (SOPs)

Qualifications & Experience

• Bachelor’s degree in paralegal studies, legal studies, or related field is required
• Minimum 3 years of paralegal experience, preferably in healthcare regulatory compliance
• Knowledge of Medicare regulations and healthcare coding practices
• Experience with case management systems and legal document preparation
• Strong analytical and legal research skills
• Excellent writing abilities, particularly for legal documents and memorandums
• Meticulous attention to detail with strong organizational skills
• Ability to track multiple deadlines and manage competing priorities

Preferred Qualifications

• Paralegal certification
• Experience with Salesforce or similar case management systems
• Knowledge of CMS-HCC risk adjustment model
• Familiarity with medical coding and documentation requirements
• Prior experience with administrative hearing processes

Take the Next Step

If you are a detail-oriented and experienced Medicare Appeals Paralegal ready to advance your career, we encourage you to apply today. Join a team committed to supporting fair hearings and making a meaningful impact in healthcare administration.

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Full-time

Job function

• Job function

  Administrative and Legal

• Industries

  Business Consulting and Services and Professional Services

Referrals increase your chances of interviewing at Talent Advantage Partners by 2x

Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

Pension plan

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