Paralegal IV

Paralegal - Medicare Appeals Support SpecialistMed-prov, LLCAbout UsMed-prov, LLC is a leading provider of specialized administrative and legal support services for healthcare organizations. We are currently supporting the Centers for Medicare & Medicaid Services (CMS) Office of Hearings in administering fair and independent hearings for healthcare providers, with a focus on Risk Adjustment Data Validation (RADV) appeals processes.Position OverviewWe are seeking a detail-oriented Paralegal with experience in healthcare regulations to support our work with CMS Office of Hearings. In this role, you will provide administrative, legal, and case management support for Medicare RADV appeals processes, with a focus on Level II appeals to CMS Hearing Officers.Primary Responsibilities•             Review and analyze appeal requests and supporting documentation for completeness, timeliness, jurisdiction, and standing•             Identify and categorize motions, objections, and preliminary legal matters•             Process and track appeals throughout their lifecycle using the Office of Hearings Case and Document Management System (OH CDMS)•             Schedule and coordinate pre-hearing conferences and hearings (record, virtual, and in-person)•             Prepare notices, correspondence, and other required documentation•             Attend pre-hearing conferences and hearings to document proceedings•             Draft legal memoranda with analysis and recommendations for hearing officers•             Research and apply relevant regulations, particularly 42 CFR § 422.311•             Draft proposed decisions addressing appealed issues with appropriate legal citations•             Maintain electronic case files and documentation in compliance with CMS requirements•             Support development and refinement of Standard Operating Procedures (SOPs)Required Qualifications•             Bachelor's degree in paralegal studies, legal studies, or related field•             Minimum 3 years of paralegal experience, preferably in healthcare regulatory compliance•             Knowledge of Medicare regulations and healthcare coding practices•             Experience with case management systems and legal document preparation•             Strong analytical and legal research skills•             Excellent writing abilities, particularly for legal documents and memoranda•             Meticulous attention to detail with strong organizational skills•             Ability to track multiple deadlines and manage competing prioritiesPreferred Qualifications•             Paralegal certification•             Experience with Salesforce or similar case management systems•             Knowledge of CMS-HCC risk adjustment model•             Familiarity with medical coding and documentation requirements•             Prior experience with administrative hearing processes•             Background in healthcare appeals or Medicare/Medicaid programsWhat We Offer•             Competitive salary commensurate with experience•             Comprehensive benefits package•             Professional development opportunities•             Flexible work arrangements•             Collaborative team environmentLocationFully RemoteSalary: Salary range between $62,850 - $89,000