Claim examiner Jobs in Washington, DC

Paralegal Specialist ROLE We need an experienced Paralegal Specialist to support the Department of Health and Human Services (HHS) Departmental Appeals Board (DAB).

The DAB adjudicates Medicare appeals and other administrative cases requiring certified records and accurate case documentation.

In this role, you will prepare certified administrative records for federal court, process and docket Medicare appeals, maintain case files in DABACTS and e-Filing systems, and coordinate with HHS contractors to obtain or complete case files.

This is a full-time opportunity.

We can offer a competitive salary, and a comprehensive benefits package.

Apply today! RESPONSIBILITIES Prepares certified administrative records for U.S.

Federal or District Court and screens claim files for completeness and jurisdiction Dockets new appeals in DABACTS and/or e-Filing systems and maintains accurate case tracking Contacts HHS contractors to obtain Administrative Law Judge (ALJ) claim files and retrieves electronic ALJ files from secure servers Converts ALJ final action documents into PDF format using Adobe Pro and uploads to DABACTS or e-Filing systems Conducts initial screening of Medicare appeals within seven working days of assignment Cures claim file defects by obtaining missing hearing files or ALJ decisions and uploads received items the same day Prepares and uploads interim letters to correct case processing errors within seven working days of assignment Contacts parties to request authorization to email Council decisions during telework operations Saves copies of issued Council decisions to the shared J drive weekly Prepares and ships boxes of closed cases to CMS contractors or Quality Associates Incorporated (QAI) for digitization (on-site only) Scans and uploads paper components of claim files to enable telework processing Processes and logs all incoming appeal requests and correspondence within two business days and refers unusual correspondence to the COR Completes docketing of requests for review, prepares acknowledgment letters, and requests claim files within two business days Updates DABACTS to reflect claim file receipt, case information, and case location within two business days Prepares, mails, and uploads final decisions, orders, and letters within prescribed timeframes in accordance with release instructions REQUIRED EDUCATION / CERTIFICATIONS Master’s or equivalent graduate degree (e.g. - J.D., LL.B, or similar) OR Two (2) years of higher-level graduate education leading to the acquisition of such a J.D., LL.B, or similar REQUIRED EXPERIENCE / SKILLS Educational experience may be substituted in lieu of one year of experience conducting legal research; preparing and reviewing legal documents / briefings and other memorandum; experience analyzing legal documents; and utilizing a variety of forums to conduct research of various laws LOCATION Washington, DC 20201 CLEARANCE U.S.

Citizenship and ability to pass background investigation to handle sensitive information CLIENT Department of Health and Human Services, Office of the Secretary, Departmental Appeals Board TRAVEL Minimal travel required (if any) WORK HOURS 40 hours per week 8 hours per working day EMPLOYMENT CLASSIFICATION Employment Classification Eligibility — W2 RELOCATION May be eligible for relocation benefits West 4 th Strategy is an Equal Opportunity (EEO) employer.

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, gender, sexual orientation, ancestry, national origin, age, marital status, mental disability, physical disability, medical condition, pregnancy, political affiliation, military or veteran status, or any other basis prohibited by federal or state law. Other Considerations:

• applicants will be subject to a background investigation.
• Individual’s primary workstation is located in an office area.
• The noise level in this environment is low to moderate.
• Regularly required to sit for extended periods up to 80% of the time; frequently required to move about to access file cabinets and use office equipment such as PC, copier, fax, telephone, cell phone, etc.
• Occasionally required to reach overhead, bend, and lift objects of up to 10 lbs.
• Specific vision abilities required by this job include the use of computer monitor screens up to 80% of the time. Powered by JazzHR