Senior Post QME Paralegal (Worker's Compensation)

WHAT YOULL DO 

Youll lead the team through the post-QME stage of each case and own the most complex matters yourself. Your responsibilities will include: 

Team Leadership & Quality Assurance 

• Assist the manager and support the Post-QME teams daily operations 

• Train and onboard new team members on post-QME procedures systems and firm standards 

• Serve as the first line of support for team member questions and escalated issues 

• Conduct regular case audits to ensure records diagnostics and filings are handled accurately and on time 

• Help distribute case assignments evenly and monitor team workload 

• Step into any team member role when needed to keep cases moving 

• Prepare and update weekly team metric reports 

• Recommend process improvements to increase efficiency and reduce delays 

Medical Record Procurement & Submission (Complex & Escalated Cases) 

• Review QME report data and identify all outstanding records requested by the evaluator 

• Contact clients to determine where they have treated and gather provider facility and treatment history information 

• Request obtain organize and submit medical records to QMEs and AMEs 

• Track outstanding record requests and follow up with providers to ensure timely receipt 

• Maintain accurate documentation of all requests communications and submissions in the case management system 

Subpoenas & Discovery 

• Prepare and process subpoenas for medical employment wage and other relevant records 

• Coordinate service of subpoenas and monitor compliance 

• Review subpoena responses for completeness and identify missing records requiring follow-up 

• Assist in obtaining declarations and supporting documentation for discovery disputes 

Diagnostic Testing Coordination 

• Review QME recommendations for diagnostic studies including: 

• MRI scans X-rays and CT scans 

• EMG/NCV studies 

• Laboratory testing and other 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 appointment details to clients and ensure attendance 

• Obtain completed diagnostic reports and submit them to the appropriate physicians and parties 

Defense Communication & Follow-Up 

• Communicate with defense counsel and insurance representatives regarding outstanding authorizations records and diagnostic testing 

• Monitor deadlines and follow up on unanswered requests 

• Escalate unresolved issues when authorizations records or diagnostic studies are delayed 

• Prepare correspondence demanding compliance with QME recommendations and discovery obligations 

WCAB Litigation Support 

• Identify situations requiring judicial intervention due to delays denials or failure to comply with QME recommendations 

• Prepare and file: 

• Declarations of Readiness to Proceed (DORs) 

• Status conference and expedited hearing requests 

• Discovery-related petitions and supporting documentation 

• Assist attorneys and hearing representatives with hearing preparation 

Client Communication 

• Educate clients on the importance of obtaining records and completing diagnostic testing 

• Coordinate scheduling and provide appointment reminders 

• Document all client communications in the case management system 

WHO YOU ARE 

We care about who you are as much as what you know. The strongest candidates for this role are: 

• Natural leaders you train coach and support teammates and set the standard for quality 

• Detail-obsessed you catch the missing record before the QME does and you catch it in an audit before it becomes a problem 

• Deadline-driven you manage time track every outstanding item and follow up without being reminded 

• Client-focused you explain the process clearly and keep injured workers informed and on schedule 

• Persistent communicators you negotiate with defense providers and vendors and dont let requests go unanswered 

• Critical thinkers you analyze medical records and know when a delay calls for litigation 

• Accountable owners you take full ownership of your cases and see them through 

Qualifications :

QUALIFICATIONS 

Required: 

• 3 years of California workers compensation paralegal experience including significant post-QME/AME work 

• Experience training mentoring or leading other paralegals or case staff 

• In-depth knowledge of QME/AME regulations discovery 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 (Word Outlook Teams) and case management systems 

• Ability to work independently and stay productive in a remote environment 

• Reliable high-speed internet and a quiet private workspace 

Preferred: 

• Applicant-side workers compensation experience 

• Prior lead senior or supervisory paralegal role 

• Experience with case audits quality assurance or metric reporting 

• Experience coordinating diagnostic testing and working with utilization review 

• Familiarity with medical terminology and medical record analysis 

• Bilingual in English and Spanish a plus 

HOW YOULL BE MEASURED 

• Timely procurement and submission of QME-requested records 

• Prompt coordination of diagnostic studies and follow-up appointments 

• Consistent communication with clients providers defense counsel and vendors 

• Accurate and timely filing of DORs and other litigation documents when disputes arise 

• Effective management of case deadlines and outstanding action items 

• Team performance against weekly metrics and audit results 

• Successful onboarding and development of new team members 

• Complete and accurate case documentation in the firms case management system 

Additional Information :

What We Offer:

• Competitive pay: $28-33 hourly based on experience
• Comprehensive benefits: health insurance and retirement plans
• Room to grow: real opportunities for professional development and career advancement
• A supportive culture: a team built on collaboration integrity and excellent client service  Meaningful work: help injured workers get the care and support they deserve

Department

Workers Compensation

Employment Type

Full Time

Location

California

Workplace type

Remote/Hybrid

Compensation

28 - 33 hourly based on experience

#ZR

Remote Work :

No

Employment Type :

Full-time