Medical Insurance

LITIGATION & MEDICAL PARALEGAL - ** YEARS

Qualification Summary

Experienced Paralegal seeking position within the Legal, Healthcare,

Compliance, Corporate or Insurance industry. Successful in extensive

Management, Litigation and Trial Preparation for Complex Cases in the areas

of Personal Injury (general and auto liability), Insurance Defense,

Wrongful Death, Multi-District Litigation, Medical Malpractice, Product

Liability, Intellectual Property Law, Labor Law, Appeals-US & State,

Worker's Compensation, Professional Malpractice, Construction Negligence,

Corporate Law and Contracts, Environmental Law and Pharmaceutical/Medical

Devices Litigation.

In addition, I am highly successful in ensuring compliance with existing

laws, regulations and requirements; identifying, investigation, and

evaluation of compliance risks, implementation initiatives, remedial

initiatives/plans and training, and audits and Risk Management; Drafting

Insurance Coverage Opinions; Drafting and commencement of Release of

Information and Records Retention standards/policies, and medical facility

policies and procedures; and Credentialing and Privileging of health care

providers and health care facilities, and compliance, certification,

accreditation, proficient testing, improvement programs, quality assurance,

quality systems and measurements pertaining to DHSS, HIPAA, CLIA, CAP, CMS

(Medicare/Medicaid), COBRA, JCAHO, DOI (Insurance), DLS, AMA, Medical

Board, Peer Review, NCQA, DHHS and CDC.

Core Competencies

Strong Work Ethic Proven Ability to Work Independently &

Extremely Dependable Prioritize

Excellent Time Management skills Collaborative Team Player

Analytical and Problem Solving skills Leadership Capability

Expert level Computer skills Successful Complex Project Management

Proficient in Medical & Legal Customer Relations skills

Terminology Research and Analysis skills

Proven Ability to Multi-Task Investigation and Interview skills

Advanced Medical & Legal Research Verbal and Written Communication skills

skills

Judgment & Decision Making skills Extremely Organized

CAREER BACKGROUND

LAW FIRMS & CORPORATIONS (Pharmaceutical, Healthcare, Insurance, & Finance)

and KIMBERLY TAYLOR, ATTORNEY AT LAW

Part-time and Full-time temporary paralegal, compliance coordinator, etc. APR 2010-Present

Litigation paralegal

apr 2010-present

. Extensive/Advanced Case Management, Document Drafting, and Trial

Preparation of Personal Injury, Intellectual Property Law, Medical

Malpractice and Family Law files trial preparation. Drafting

insurance coverage opinions and claim evaluations and claims

administration. Negotiations of claims resulting in case settlements

ranging from $25,000.00 to $1,000,000.00 and lien

reductions/dismissal.

. Corporate liaison (attorney supervised) for questions pertaining to

Compliance, Remedial Actions/Plans, Risk Management, Credentialing and

Privileging, and issues regarding third-party insurance,

Medicare/Medicaid, COBRA and private health insurance

accreditation/certification and coverage, Human Resources.

. Management of potential Liability Lawsuits/claims; Primary corporate

administrator for document/contract management system and outside law

firm billing software (e-billing), and data input of same

documents/billing.

. Drafted Contracts and Agreements, Confidentiality/Non-Disclosure

Agreements, Consulting Agreements, Vendor Contracts, etc.

Lewis & Daggett, P.A. (currently split into 2 firms) (

winston-salem, nc

Litigation paralegal mar 2006-apr

2010

. Extensive Case Management, Document Drafting, and trial preparation of

30-60 Personal Injury, Wrongful Death, DWI, Slip and Fall, Tractor

Trailer, etc. litigation files; Successful Negotiations of claims

resulting in case settlements ranging from $25,000.00 to $1,000,000.00

and reductions/dismissal of third-party, Medicare/Medicaid, COBRA and

private health insurance liens. Assistance of expertise with Worker's

Compensation and Social Security Disability cases/matters.

. Drafted Appeal pleadings and Record on Appeal, and drafting of and

legal research for brief.

. Legal and medical research; and Management of docketing system and

documents and case management systems.

. Participation, organization and promotion of Safe and Sober Prom Night

program; attended and interacted with students at schools' Safe and

Sober Prom Night events throughout the State of North Carolina.

wilson & iseman, llp (firm currently split)( winston-salem,

nc

Medical-litigation paralegal jul 2005 - mar

2006

. Extensive Case Management, Document Drafting, and trial preparation of

30-100 Medical Malpractice, Personal Injury, Wrongful Death, DWI, Slip

and Fall, Tractor Trailer, Intellectual Property, etc. litigation

files; Investigation and Interview; Successful settlement claims

negotiation; Legal and medical literature research.

. Primary liaison for Attorneys, hospital personnel, health care

providers/facilities, physicians, insurance adjusters, insurance

carriers, state and federal governing/regulating agencies, and claims

specialists concerning issues on Peer Review, JCAHO Compliance, CLIA,

Physician, Health Care Facility, Clinical Laboratory, Hospital, Clinic

Credentialing and Privileging, Compliance and Audits, Risk Management,

HIPAA Compliance, Claims Administration, Policies and Procedures, and

Coverage, and issues pertaining to third-party insurance,

Medicare/Medicaid, COBRA and private health insurance

certification/accreditation and coverage; drafting and implementation

of Policies and Procedures.

. Drafting documents/contracts and management of Real Estate, Probate

and Estates and Estate Planning, Employment and Labor Law/Litigation

and Corporate Matters.

. Assistant IT support and maintenance of firm computer system, network

administration, and Administrator of case and document management

system, and data input.

bennett & guthrie, pllc ( winston-salem, nc

medical-litigation-insurance defense paralegal jul 1997-jun

2005

. Case management of ALL cases for 4 attorneys ranging in the areas of

Personal Injury, Medical Malpractice, Intellectual Property Law,

Employment/Labor Law, Nursing Home, Mental Health Facilities and Child

Care Negligence/Abuse Wrongful Death, and Worker's Compensation, Multi-

District Litigation, Asbestos/Lead Paint Poisoning Litigation, Tobacco

Litigation, Class Actions and Complex Litigation cases. Investigation

and Interview. Successful settlement claims negotiation. Legal and

medical literature research.

. Primary liaison for Attorneys, hospital personnel, health care

providers/facilities, physicians, insurance adjusters, insurance

carriers, state and federal governing/regulating agencies, and claims

specialists concerning issues on Peer Review, JCAHO Compliance, CLIA,

Physician, Health Care Facility, Clinical Laboratory, Hospital, Clinic

Credentialing and Privileging, Compliance and Audits, Risk Management,

HIPAA Compliance, Claims Administration, Policies and Procedures, and

Coverage, and issues pertaining to third-party insurance,

Medicare/Medicaid, COBRA and private health insurance

certification/accreditation and coverage; drafting of HIPAA

Authorizations and Policies and Procedures.

. Drafting documents/contracts and management of Real Estate, Probate

and Estates and Estate Planning and Corporate Matters.

. IT Administrator for document and case management systems and support

for firm computer system, network administration, etc.; Managed client

(insurance companies and hospitals/medical facilities) billing and

coding for law firm bills/invoices, Accounts Payable and Accounts

Receivable; Monthly/Quarterly Reports and other Administrative duties

for the Firm.

. Organization of campaign fund raisers for Judicial candidates;

Assisted on Election Day at campaign headquarters for same Judicial

candidates.

starnes & atchison( birmingham, al

medical-litigation-insurance defense paralegal jul 1991-jun

1997

. Advanced Case Management, Document Drafting and Trial Preparation of

ALL cases for 1 Senior Partner and the 4 Associates assigned to the

Senior Partner in the areas of Medical Malpractice, Intellectual

Property Law, Personal Injury, Wrongful Death, Nursing Home and Mental

Health Facilities, Aviation Litigation, Multi-District Litigation,

Mass Torts, Honda ATV, Breast Implant, Pharmaceutical/Medical Devices

Litigation, Class Actions and Complex Litigation cases; Investigation

and Interview. Successful negotiation of settlement of claims; Legal

and medical literature research.

. Primary liaison for Attorneys, hospital personnel, health care

providers/facilities, physicians, insurance adjusters, insurance

carriers, state and federal governing/regulating agencies, and claims

specialists concerning issues on Peer Review, JCAHO Compliance, CLIA,

Physician, Health Care Facility, Clinical Laboratory, Hospital, Clinic

Credentialing and Privileging, Compliance and Audits, Risk

Management, HIPAA Compliance, Claims

Administration, Policies and Procedures, and Coverage, and issues

pertaining to third-party insurance, Medicare/Medicaid, COBRA and

private health insurance certification/accreditation and coverage;

drafting and implementation of Policies and Procedures.

Coordinator, Attendee and Speaker at Seminars for Hospital Personnel

and Other Health Care Providers on Compliance, Importance of Medical

Charting and Documentation in Litigation of Malpractice Claim, HIPAA

and JACHO Compliance, etc.

clark & scottt, attorneys at law( birmingham, al

medical-litigation-insurance defense paralegal may 1990-jul

1991

. Extensive Case Management, Document Drafting, and Trial Preparation of

ALL cases for 1 Senior Partner and the Associates assigned to the

Senior Partner in the areas of Medical Malpractice, Personal Injury,

Intellectual Property Law, Worker's Compensation, Wrongful Death,

Nursing Home and Mental Health Facilities, Multi-District Litigation,

Mass Torts, Pharmaceutical/Medical Devices Litigation, Class Actions,

Complex Litigation, Motor Carrier/Tractor Trailer and Logging, Oil and

Utility Vehicles, Negligent Child Care Facility, Family Law cases;

Successful negotiation of claims settlements. Legal and medical

literature research.

. Drafted case summaries/evaluations and monthly, quarterly, annually

and pre-trial reports and coverage opinions for insurance carriers

(clients).

Education

University of Arkansas at Little Rock, Little Rock, Arkansas

Bachelor of Arts Degree-Political Science; Minor-English - Graduated with

3.8 GPA

South Central Career College, Little Rock, Arkansas

ABA approved Paralegal Program-Paralegal Studies Certificate - Graduated

with 4.0 GPA

Little Rock Central High School, Little Rock, Arkansas - Graduated with 3.8

GPA

accomplishments/special

skills

. Youth and Adult Sports Referee at Jerry Long YMCA from 2000-present.

. Expert in Word/XP/2007, WordPerfect, Access, Needles, Lotus, Excel,

Outlook, SAP, Compliance 360? Programs, MetricStream Compliance,

Oracle, Net Suite, Microsoft Dynamic, PeopleSoft, Amicus Attorney,

ProLaw, Worldox, HotDocs, Timeslips, SharePoint, Contract Assistant-

Contract Management Solution, ebilling, ediscovery, Concordance,

Summation, QuickBooks, Medline, Westlaw, Allegiant, CaseMap, TimeMap,

PowerPoint, Multi-District Litigation document system, PACER, and

Medical/Insurance Diagnosis and Coding.

. Development and initiation of Medico/Legal/HIPAA Forms, Agreements and

Authorizations, Policies and Procedures for NC Bar Association &

Medical Facility/Health Care Providers.

. NC Certified Paralegal.

. Member of NC Bar Association Paralegal Division from 1992-2006.

Contact this candidate