Jurisdictional Analyst

This is a fully remote position, open to applicants in Maryland.

📋 Description

• Assess if a corporate conflict of interest hinders Commence from reviewing a dispute.

• Exclude cases that are subject to a previous decision involving the same parties within the 90-day cooling-off period.

• Verify if the regulatory timelines required for jurisdiction have been satisfied.

• Establish whether the case jurisdiction falls under state or federal law.

• Draft suitable jurisdictional determinations.

• Provide essential information for medical coders, nurses, and legal arbitrators when federal jurisdiction is applicable.

• Prioritize tasks and identify when to escalate issues, concerns, or discrepancies to the supervisor.

• Review medical records to aid in final IDR determinations.

• Utilize knowledge of healthcare insurance operations and relevant state and federal medical and jurisdictional regulations.

• Proactively address potential issues.

• Safeguard patient information in accordance with HIPAA and HITECH regulations.

⛳️ Requirements

• An associate degree with a focus in paralegal studies, or a bachelor’s degree in legal services or business administration with a concentration in paralegal studies and/or a Paralegal certification; relevant experience may substitute for formal educational requirements.

• Exceptional attention to detail, along with strong proofreading and organizational abilities.

• Superior oral and written communication skills with internal stakeholders.

• Capability to manage multiple projects, task functions, and intricate contractual obligations simultaneously.

• Proficient in Microsoft Office Suite, particularly Word and Excel.

• Outstanding organizational and time management capabilities.

• Clear, concise, and logical writing style.

• Ability to juggle competing priorities with varying deadlines while collaborating effectively with attorneys, professionals, and other staff members.

• Preferred: familiarity with insurance claims processing, medical coding, and claim rejections.

• Medical coding certification is preferred.

🏝️ Benefits

• Comprehensive health and wellness programs.

• Opportunities for professional development and advancement.

• Collaborative and supportive work environment.

• Flexible working hours and remote work options.