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.
Requirements
- 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
Benefits
- Comprehensive benefits package
