PIP Arbitration Pre-Filing Paralegal

Summary:

The Pre-Filing PIP Arbitration Paralegal is primarily responsible for preparing PIP Arbitrations to be filed. The tasks will include, but not be limited to the preparation of the fee schedule, review and/or submission of appeals, and preparation of the exhibits in support of the Demand for Arbitration. In addition, the Pre-Filing PIP Arbitration Paralegal will be responsible for follow up of missing documentation, as well as notifying clients if a file cannot be pursued.

Overview:

• New File Review
  • Organization and review of AOB, bills, EOBs, medical records, pre-certification requests, appeals, etc.
  • Communication with medical providers, insurance companies, attorney offices, etc. to obtain missing or incomplete documentation.
  • Preparation of fee schedule breakdown.
  • Analysis of existing appeals for accuracy.
  • Preparation of the New File Check List.
  • Insurance calls.
• Preparation and submission of post-service appeals.
  • Prepare post-service appeal form.
  • Prepare narrative.
  • Organize necessary supporting documentation.
• Filing of Demands for Arbitration via eLaw.
• Review of provider systems to locate potential PIP Arbitrations.
• Preparation and submission of amendments.
  • Update fee schedule breakdown.
  • Organize necessary supporting documentation.
  • Preparation of cover letter.

Qualifications:

• At least 2 years of relevant PIP arbitration experience.
• Ability to properly fee schedule all medical specialties (MRI, chiropractic, physical therapy, acupuncture, orthopedic, neurologic, pain management, surgery, ASC, hospital, etc.)
• Familiarity with all associated documentation (AOB, bills, EOBs, medical records, pre-certification requests, pre and post service appeals, etc.)
• Ability to review pre and post service appeals for accuracy.
• Ability to prepare post service appeals.
• Paralegal Certification, Bachelor Degree or relevant experience.