Paralegal, Legal Services Specialist
Common Ground Healthcare Cooperative (CGHC) is a nonprofit, community-owned health insurance company well positioned to grow into a major force for positive change in the Wisconsin health insurance market. We are a member-governed cooperative with a mission to provide affordable, innovative health insurance solutions to small businesses, non-profits and individuals in Wisconsin. CGHC is looking for a Paralegal, Legal Services Specialist who believes in our mission, is comfortable working in an exciting, fast-paced environment and who is compatible with our team of hardworking, fun and committed staff.
The Paralegal, Legal Services Specialist will support the General Counsel in the day to day functions of the Legal and Compliance Department. This position is responsible for a variety of legal support duties, including researching laws, regulations and other legal requirements relevant to health insurance; manage the subrogation process, including analysis of claims and recoveries; contract drafting and review; advertising review; interaction with internal clients regarding contracts, audits and legal issues; and analysis of changes in laws that affect business areas.
Essential Duties, Responsibilities
- Legal Research: Gather background information, research the law and/or regulations on specific issues or questions. Prepare and present a summary of the findings, including initial analysis, as requested, to the General Counsel and Chief Compliance Officer.
- Contracts / Agreements: Responsible for drafting, reviewing, and revising contracts and/or agreements.
- Material Review: Review materials for members, providers, agents, and/or pharmacies (letters, training materials, marketing pieces etc.) for legal compliance.
- Manage Subrogation: Manage intake process; work with vendor to obtain and distribute information; analysis of related data.
- Complaint Reporting: Prepare monthly report regarding all complaints, grievances and appeals, including summary of issues; identify trends.
- Project Coordination / Management: Ability to coordinate projects within our team and/or with other departments within the organization. The role would be to organize, manage communication and track progress on assigned projects. Some projects may require working with external entities, including state regulatory bodies.
- Perform other duties as assigned.
Knowledge and Skill Requirements
- Bachelor’s Degree or Legal/Paralegal Certificate with at least 3 years of relevant experience
- Proficient with Microsoft Office Suite
- Experience working with contracts preferred – contract review, drafting and negotiating skills.
- Project Management – experience managing projects with multiple key owners, several components, and changing time frames.
- Experience in the healthcare or health insurance industry is a plus.
- Excellent communication skills – written and verbal.
- Detail Oriented – ability to review brochures, letters, contracts, training materials, etc. looking for legal compliance and clarity of description.
- Strong analytical, problem solving and organizational skills.
- Demonstrated research skills utilizing a variety of vehicles.
- Demonstrated ability to simultaneously manage a variety of assignments, and oversee areas of responsibility and prioritize activities in a fast-paced environment.
- An independent thinker; able to make decisions quickly but also seek guidance when appropriate.
- Professional demeanor and ability to interact with persuasiveness and confidence.
- Demonstrated relationship-building skills and ability to appreciate people with different backgrounds and points of view and ability to create an inclusive environment.
- Personal integrity, sound judgment and strong ethics in business and personal conduct.
- Ability to treat others with dignity, respect, and courtesy required.
- Ability to follow operating procedures and practices.
- Ability to maintain member, employee, and proprietary confidentiality required.
- Ability to communicate effectively in-person and in all forms of communication required.
- Ability to pay attention to detail required.
- Ability to be flexible and adapt to changing situations required.
- Ability to adhere to punctuality/attendance standards required.
- Ability to provide professional image as outlined in the professional casual dress policy required.
Join a winning team of committed professionals in a growing enterprise. Qualified applicants should send their cover letter, resume and salary requirements to email@example.com or Common Ground Healthcare Cooperative, Attn: Human Resources, 120 Bishop’s Way, Suite 150, Brookfield, WI 53005.