Medical Paralegal Specialist

13 hours ago

Englewood, New Jersey, United States Progressive Spine & Orthopaedics, LLC Full time
Medical Paralegal Job Description

We are seeking a highly skilled and detail-oriented Medical Paralegal to join our team at Progressive Spine & Orthopaedics, LLC. As a Medical Paralegal, you will play a critical role in supporting our medical professionals with legal issues that arise during treatment, submitting claims, and appealing underpaid and/or denied claims on behalf of out-of-network providers.

Key Responsibilities:
  • Follow up on submitted medical bills, including major med, PIP/MVA, and WC claims.
  • Draft appeal letters on behalf of providers and patients to overturn insurance denials/underpayments and reduce patient responsibility.
  • Answer phones and handle inquiries from patients, attorneys, insurance adjusters, and other stakeholders.
  • Communicate directly with patient attorneys to resolve outstanding balances, including negotiating settlements.
  • Prepare reports on case status, including details about pending cases, status updates, and any issues that may have arisen.
  • Review medical records to ensure they are complete and accurate.
  • Research case law, medical literature, and other sources to identify relevant precedents or gather facts relevant to a case.
  • Coordinate with others working on the case to gather needed information for further processing.
  • Collect information from medical experts or other sources regarding cases involving complex medical issues.
  • Organize files and maintain case documentation.
Requirements:
  • Associate degree in paralegal studies, legal studies, or a related field.
  • 2+ years of experience as a medical paralegal or in a related role.
  • Preferred paralegal certificate and pass the Paralegal Certification Examination provided by the American Bar Association.
  • Strong understanding of medical terminology.
  • Excellent research skills.
  • Exceptional organizational skills.
  • Ability to handle confidential information with discretion.
  • Experience working in a law firm or medical office.
  • Knowledge of state and federal laws governing healthcare.
  • Familiarity with electronic medical records systems.
  • Proficiency in Microsoft Office, Adobe Acrobat, and medical billing software.
Benefits:
  • Competitive salary and benefits package.
  • Health, dental, and vision insurance.
  • Retirement savings plan.
  • Paid time off and holidays.
  • Opportunities for professional development and growth.
  • Collaborative supportive work environment.

We are committed to maintaining a safe and drug-free workplace. As part of our hiring process, all candidates who receive a job offer will be required to undergo a pre-employment drug test and background check. These steps are essential to ensure the safety and well-being of our employees and patients.

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