Estimated Length: 12 months M-F; 9am-5pm, 37.5-40 hours/week

Requirements

Evaluate External Appeal applications for eligibility based on requirements in Insurance Law Article 49.  Request necessary information from appropriate party and respond to questions about the process.  Investigate complaints against regulated insurance companies, applying mandates in Insurance Law and provisions in the approved policy.  Request necessary information from appropriate party and communicate findings when the investigation is complete.  Client will train the paralegal on the internal process and applicable Laws.

Duties:
• Screen requests for Appeals in accordance with the Federal No Surprise Act.
• Screen requests for External Appeal in accordance with Insurance Law, Regulation and the established protocols.
• Act as liaison using written and verbal communication for administrative processes with consumers and representatives of financial entities.
• Keep electronic case files updated, complete and organized.
• Research, process and resolve consumer and provider complaints.

Skills/Qualifications:
• Excellent writing and communication abilities are preferred.
• Should be a self-starter, outgoing and team-oriented.
• Strong attention to detail and organizational skills are a must.
• Ability to understand legal mandates
• Ability to work effectively and professionally with higher level management staff is essential.  
• Computer proficiency in Microsoft Office Suite, including Outlook, Word, Excel, etc. is a mandatory component of the assignment.  
• Reliability, and time and attendance is critical.
• Must have knowledge of basic legal processes; legal terminology and legal
forms; legal research techniques; ability to read, understand and interpret laws, legal documents and other
written material. 
• Paralegals must possess paralegal certification. Legal assistants must possess a minimum
of an associate degree in legal assistance OR an associate degree and a certificate of completion of a Legal
Assistant Certificate Program from an accredited college.

Additional information:
- The position is for 37.5 hours per week, but overtime may be available at times 
- A background check and fingerprinting will be required, including verification of education and employment
- Interviews will be conducted via Microsoft Teams.
- Client does not provide parking, but the office is accessible by bus and metered parking is available around the building
- Once training has been provided, Client currently has a 50% telecommuting policy in place. 
- Basis for award is a combination of lowest price and best value. Preference will be given to certified MWBE/SDVOB companies.

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