Risk Claims Management Paralegal

Adventist Health System; Town of Florida (NY); Remote; USD 50,000 - 70,000; Full time

Job summary

A healthcare organization is seeking a Paralegal to manage the claims process, ensuring compliance with regulations. The role requires 5+ years of experience, an Associate’s Degree, and strong organizational and communication skills. This full-time position allows for remote work, providing an opportunity to be part of a caring community dedicated to serving others.

Benefits

Benefits from Day One

Paid Time Off from Day One

Career Development

Whole Person Wellbeing Resources

Mental Health Resources and Support

Qualifications

• 5+ years of experience in a professional role as a paralegal or related work.
• Experience in handling highly confidential information.

Responsibilities

• Manages all aspects of the claims process.
• Ensures compliance with federal and state regulations.
• Develops policies for claims processing.

Skills

Outstanding communication skills

Organizational skills

Stress management skills

Time management skills

Education

Associate’s Degree

Bachelor’s Degree

Job description

Benefits and perks you need for you and your family:

• Benefits from Day One
• Paid Time Off from Day One
• Career Development
• Whole Person Wellbeing Resources
• Mental Health Resources and Support

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: Full Time

Shift: Monday - Friday

Location: Remote

The role you’ll contribute:

The paralegal provides the professional support necessary for AdventHealth claims team to meet the day-to-day functions of the department. Document preparation and distribution, project management, organizational and time management skills are important to effectively complete job assignments. Outstanding communication and stress management skills are extremely important. Experience in handling highly confidential information is a vital part of their daily responsibilities. The paralegal performs all delegated duties under the general supervision of the claims team.

The value you’ll bring to the team:

• Manages and oversees all aspects of the claims process.
• Ensures compliance with federal and state regulations.
• Provides expert guidance on operations intersecting with patient privacy regulations and consumer data protection laws.
• Develops and implements policies and procedures for claims processing.
• Monitors and evaluates the effectiveness of claims processing activities.
• Coordinates with legal and compliance teams to address regulatory issues.
• Conducts training and education for staff on claims processing and compliance requirements.
• Reviews and analyzes claims data to identify trends and areas for improvement.
• Collaborates with other departments to ensure seamless operations and compliance.
• Investigates and resolves complex claims issues.
• Prepares and submits reports to regulatory agencies as required.
• Stays updated on changes in laws and regulations affecting claims processing.
• Other duties as assigned.

The expertise and experiences you’ll need to succeed

Education and Experience Required

• Associate’s Degree
• 5+ years of experience in a professional role as a paralegal or related work experience

Education and Experience Preferred

• Bachelor’s Degree

Licensure, Certification, or Registration Preferred

• Certified Paralegal (CP)