STATE OF CONNECTICUT EXECUTIVE BRANCH JOBS

Paralegal Specialist

Recruitment #180608-6142AR-001

Introduction

The Office of the Healthcare Advocate (OHA) located at 450 Capitol Ave, Hartford, CT is recruiting for a Paralegal Specialist position.  This is a full-time (40 hours per week M-F) position.    

The selected candidate will be responsible for analyzing complex cases; assess whether health insurance denials are appropriate and legally compliant and provide recommendation to management; interview clients, draft and/or reviews appeal letters and other documents; identify applicable deadlines and time frames and other applicable administrative procedure requirements, based on contractual policy language, and state and federal statutes and regulations.  Develops strategies and drafts appeals for denials of care by public and private payers, represents client's interest at hearings or through case presentation.  Negotiates and attempts to settle case with insurance carrier, prepares draft legal documents.  Performs legal research and analysis of law sources such as statutes, legal articles, legal decisions, opinions, rulings, memoranda and other legal materials.

Please include your resume with you application.  Please ensure your application is complete.  You will be unable to make any changes once you submit your application in the JobAps system.

Should you have questions pertaining to this recruitment, please contact cid.hr@ct.gov or (860) 297-3936.

PURPOSE OF JOB CLASS (NATURE OF WORK)

In a state agency, this class is accountable for providing advanced paralegal support in a highly complex legal unit. This class provides advanced technical leadership, research and consultation in the areas of preparing draft legal documents and draft decisions of highly complex cases; as a resource regarding issues, procedures, process and timeframe as related to cases and presenting legal matters as needed.

EXAMPLES OF DUTIES

Performs highly complex paralegal duties as defined in one or both of the following areas:

LEGAL OFFICE OPERATIONS: Interprets complex state statutes and federal regulations governing legal records and documents; determines and applies applicable state statute and/or regulation in preparing documentation; interprets court rules and agency policies and regulations; keeps abreast of the latest court rules, calendar changes and pending legislation; monitors and adheres to court deadlines; reviews legal documents and prepares legal documents such as briefs, writs and pleadings for court filings; responds to relevant case information requests from courts; performs legal research and analysis of law sources such as statutes, legal articles, legal decisions, opinions, rulings, memoranda and other legal material; prepares draft legal documents; provides assistance in the discovery process; provides paralegal assistance by interpreting applicable legal provisions, regulations, precedents and policies; responds to requests and obtains information of sensitive nature; acts as liaison between agency, court system, relevant attorney’s offices and general public; serves as agency liaison regarding relevant policies and procedures; prepares legal and administrative reports; updates and maintains case records, pleadings, policy manuals and filing systems; assists in the drafting of proposed legislation and advisory opinions; provides training and assistance to staff; may perform business mathematical computations; performs related duties as required.

CASE PRESENTATION OR HEARING: Analyzes highly complex cases; develops positions and strategies to settle or litigate cases at formal or informal hearings; prepares for and represents State’s interest at hearings or through case presentation; researches and gathers relevant evidence and documentation; interviews witnesses and clients; drafts legal documents, complaints, stipulations, detailed memoranda, letters and proposed findings and awards reviews substantiation appeals and provides recommendation to management regarding the legal sufficiency of substantiation findings; performs related duties as required.

KNOWLEDGE, SKILL AND ABILITY

Considerable knowledge of legal processes and procedures; considerable knowledge of legal terminology and legal forms; considerable knowledge of legal research techniques; knowledge of relevant agency policies and procedures; knowledge of and the ability to interpret and apply relevant state and federal laws, statutes, regulations and legislation; considerable skill in fact finding techniques including interviewing clients and compiling evidence; considerable interpersonal skills; considerable oral and written communication skills; considerable ability to evaluate pertinent facts, cases and evidence and compile and assemble such legal data; considerable ability to compose correspondence and draft legal documents; ability to understand complex laws and related reports; ability to utilize computer software.

MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE

The General Experience is defined as one of the following:

1. A Bachelor’s degree in legal studies and one (1) year of experience providing paraprofessional legal assistance to an attorney.

2. An Associate’s degree in legal studies and three (3) years of experience providing paraprofessional legal assistance to an attorney.

3. Completion of a Paralegal or Legal Assistance Certificate Program approved by the American Bar Association and three (3) years of experience providing paraprofessional legal assistance to an attorney.

4. Completion of a Paralegal or Legal Assistance Certificate Program consisting of a minimum of twenty-four (24) semester hours from an accredited college or university and four (4) years of experience providing paraprofessional legal assistance to an attorney.

5. Completion of a Paralegal or Legal Assistance Certificate Program from a business school approved by the State of Connecticut, Office of Higher Education and four (4) years of experience providing paraprofessional legal assistance to an attorney.

6. A Law degree from an accredited Law School.

PREFERRED QUALIFICATIONS

  • Considerable knowledge of the health care industry, health insurance industry, and related policy trends and issues, with emphasis on Connecticut marketplace;
  • Considerable knowledge of and the ability to interpret and apply relevant state and federal laws, statutes, regulations and legislation particularly as they relate to health care and health insurance;
  • Experience with Affordable Care Act implementation, in particular Connecticut’s Health Insurance Exchange, Access Health CT;
  • Experience with the preparation and presentation of healthcare insurance appeals;
  • Thorough knowledge of the Affordable Care Act, Medicaid, Medicare and commercial insurance policy and appeals processes, including administrative hearing;
  • Ability to effectively present complex information and respond to questions from stakeholders, agencies and professional organizations;
  • Ability to translate and synthesize issues in lay terms;
  • Experience handling cases with clinical aspects (either medical and/or mental health), such as cases involving disputes regarding medical necessity of treatment;
  • Excellent communication, interpersonal, and organizational skills.

Conclusion

AN AFFIRMATIVE ACTION/EQUAL OPPORTUNITY EMPLOYER

The State of Connecticut is an equal opportunity/affirmative action employer and strongly encourages the applications of women, minorities, and persons with disabilities.