Description

Supports attorneys in the Office of General Counsel (OGC) by managing, at the direction of the managing attorney, payment disputes brought by members and providers. This support requires working closely with the managing attorney to assess risk, provide creative solutions, drafting pleadings and discovery, and negotiating potential settlements with opposing parties.

Responsibilities

At the direction of, and in consultation with, the managing attorney, preparation of legal documents, including various pleadings, discovery, and settlement agreements.
Investigate, organize, and analyze facts relevant to assigned matters and, at the direction of, and in consultation with, the managing attorney prepare and execute strategy to manage the same.
Proactively identify issues and anticipate support needed by attorneys and business partners.
Provide guidance and feedback to Paralegals and Senior Paralegals on certain projects and assigned matters.
Work with personnel in various court systems, BCBSM or subsidiary departments, state and federal agencies including the Michigan Department of Insurance and Financial Services, legislative/governmental staffs, and other BCBS Plan personnel.
Align with all levels of BCBSM and subsidiary management, including executive staff members.
Manage relationship with internal clients, outside counsel, and potential witnesses.
Working knowledge of Michigan Court Rules and agency procedures preferred.

QUALIFICATIONS

Bachelor’s degree, completion of an ABA-certified legal assistant program, or a Juris Doctorate from an accredited law school required.
Ten (10) years’ experience as a paralegal or five (5) years with BCBSM and working knowledge of BCBSM’s claims processing, grievance and appeals systems, and procedures.
Exceptional legal research skills and experience in legal research methods and legal writing.
Knowledge of Michigan and Federal Court rules and basic substantive and procedural law.
Working knowledge of HIPAA and ERISA rules and regulations preferred.
Experience with reviewing and applying federal and state laws, regulations, and other guidance required.
Experience required in drafting complaints, answers, affirmative defenses, subpoena and discovery requests, responses, and objections, as well as motions to dismiss/summary judgment, and discovery motions.
Proficient use of LEXIS-NEXIS or Westlaw software.
Proficient use of Microsoft Office applications including Word, Excel, and PowerPoint.
Internal candidates should be proficient in internal management systems (including 3270, IRIS, OSCAR, iManage, and CounselLink).
Internal candidates should possess working knowledge of company policies and procedures.
Must organize and prioritize assignments without constant supervision.
Must be able to analyze complex fact situations.
Exceptional written and oral communication skills and demonstrated ability to effectively coordinate with departments outside of the OGC and external entities.
Must be effective in investigating matters including interviewing relevant individuals if necessary.
Other related skills and/or abilities may be required to perform this job.

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