Post QME Paralegal (Worker's Compensation)
About The Position
The Post-QME Paralegal advances California workers’ compensation cases after Qualified Medical Evaluator (QME) examinations. This full-time remote role owns the post-QME stage of a caseload, ensuring requested medical records, diagnostic studies, and authorizations are obtained and provided to evaluators and other appropriate parties. The paralegal communicates with clients, providers, defense counsel, insurance representatives, claims administrators, and vendors, and follows up on delays or disputes. The role includes reviewing QME reports, identifying outstanding records and recommendations, preparing subpoenas, coordinating diagnostic testing, tracking deadlines, and maintaining accurate case-management documentation. When delays, denials, or failures to comply require legal action, the paralegal prepares and files WCAB-related documents and supports attorneys and hearing representatives with hearing preparation.
Requirements
- At least 1 year of California workers’ compensation paralegal or case management experience.
- Working knowledge of QME/AME procedures and WCAB litigation practices.
- Experience preparing subpoenas and filing documents such as DORs through EAMS.
- Strong written and verbal communication skills.
- Proficiency in Microsoft Office, including Word, Outlook, and Teams, and in case management systems.
- Ability to work independently and remain productive in a remote environment.
- Reliable high-speed internet and a quiet, private workspace.
Nice To Haves
- Applicant-side workers’ compensation experience.
- Experience coordinating diagnostic testing and working with utilization review.
- Familiarity with medical terminology and medical record analysis.
- Bilingual English and Spanish.
Responsibilities
- Review QME report data and identify outstanding records requested by the evaluator.
- Contact clients to identify treating providers, facilities, and treatment history.
- Request, obtain, organize, and submit medical records to QMEs and AMEs.
- Track outstanding records requests and follow up with providers.
- Document requests, communications, and submissions in the case management system.
- Prepare and process subpoenas for medical, employment, wage, and other relevant records.
- Coordinate subpoena service, monitor compliance, review responses, and follow up for missing records.
- Assist in obtaining declarations and supporting documentation for discovery disputes.
- Review QME recommendations for diagnostic studies, including MRI scans, X-rays, CT scans, EMG/NCV studies, laboratory testing, and specialty diagnostic evaluations.
- Request authorization status and vendor information from defense counsel, claims administrators, and utilization review departments.
- Coordinate appointments with approved diagnostic vendors and facilities, communicate details to clients, and ensure attendance.
- Obtain completed diagnostic reports and submit them to appropriate physicians and parties.
- Communicate with defense counsel and insurance representatives about outstanding authorizations, records, and diagnostic testing.
- Monitor deadlines, follow up on unanswered requests, and escalate unresolved delays.
- Prepare correspondence demanding compliance with QME recommendations and discovery obligations.
- Identify when delays, denials, or noncompliance warrant judicial intervention.
- Prepare and file Declarations of Readiness to Proceed (DORs), status conference and expedited hearing requests, and discovery-related petitions with supporting documentation.
- Assist attorneys and hearing representatives with hearing preparation.
- Educate clients about obtaining records and completing diagnostic testing, coordinate scheduling, provide appointment reminders, and document communications.
Benefits
- Health insurance.
- Retirement plans.
- Opportunities for professional development and career advancement.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
