Paralegal, TPA & COE

WHO WE ARE

Relation Insurance is a leading, innovative company with a strong commitment to excellence and a passion for delivering cutting-edge solutions to our clients. As a key player in the insurance market, we pride ourselves on our dynamic culture, collaborative environment, and continuous drive for success. With a rich history and a bright future ahead, we are looking for exceptional individuals to join our team and contribute to our ongoing growth and success.
 

WHAT WE’RE LOOKING FOR

The Paralegal provides experienced legal, regulatory and compliance support to Relation’s Third-Party Administrator (TPA) business and its Center of Excellence (COE) business.  The individual in this role performs substantive legal support under attorney direction, including review of routine contracts, plan-related documents, legal and regulatory research, support for disputes and appeals, regulatory filings, subpoena and information request responses, and maintenance of legal and compliance records. The Paralegal works closely with Operations, Sales, Finance, Information Technology, and other business partners to support the TPA and COE operations.

A GLIMPSE INTO YOUR DAY

• Reviews routine business contracts and supporting documentation against approved templates, playbooks, and guidelines, including client contracts, administrative services agreements, provider network agreements, business associate agreements, and vendor agreements; summarizes key terms, identifies missing or non-standard provisions, and escalates legal or business issues to an attorney.
• Prepares, reviews, and organizes playbooks, legal documents, correspondence, forms, certifications, regulatory submissions, and other materials under attorney direction.
• Conducts legal and regulatory research related to TPA and COE operations, including self-funded employee benefits plans and claims administration, and applicable federal and state requirements related thereto. Summarizes findings and identifies potential operational impacts for attorneys and internal business partners.
• Prepares responses to third-party complaints, reviews, and audits by gathering and organizing records, researching applicable requirements, drafting responses or other deliverables, and tracking deadlines.
• Responsible for the TPA’s licensing, including preparation and filing of annual reports and other filings due to regulators across applicable jurisdictions.
• Monitors filing, reporting, registration, and renewal requirements; maintains accurate tracking records and coordinates timely submissions with regulators, internal business partners and third-party service providers.
• Identifies legal and compliance risk with respect to TPA’s and COE’s operations that may develop from time-to-time, propose remedies, and implement agreed upon action plan.
• Assists with responses to subpoenas, medical record requests, regulatory inquiries, audits, complaints and internal information requests by gathering, reviewing, organizing, and tracking responsive materials under attorney supervision.
• Tracks changes in ERISA, HIPAA, COBRA, the Affordable Care Act, state insurance requirements, and other laws and regulations applicable to TPA operations, and assists Legal and Compliance leadership in evaluating related requirements.
• Serves as a legal support contact for internal TPA and COE business partners and coordinates with applicable internal and external parties under attorney direction.
• Maintains complete and accurate Legal Department files, contract records, regulatory documentation and matter data in designated electronic document and matter management systems.
• Coordinates signatures, notarizations, certifications, and document approvals after attorney review, and maintains final executed copies.
• Coordinates contract intake and routes agreements to the appropriate Legal, Compliance, operational, and executive stakeholders for review and approval.
• May provide backup support to the Corporate Paralegal and/or Legal Operations Specialist on established legal operations, licensing, records, and administrative processes.
• Responsibly applies technology and proprietary AI tools to increase the speed, accuracy, and consistency of legal work, including drafting, summarization, document comparison, research support, and issue identification, while ensuring careful review, defensible documentation, secure data handling, and compliance with applicable laws, ethical obligations, and internal AI-use guidelines.
• Performs other projects, duties, and tasks, as assigned.

WHAT SUCCESS LOOKS LIKE IN THIS ROLE

• High School diploma or equivalent required. Two or four-year degree in paralegal studies, legal studies, healthcare administration, business or related field preferred.
• Paralegal certificate from an accredited program.
• Minimum 5 years of relevant paralegal, legal support, or compliance experience supporting healthcare TPA, self-funded employee benefits plan, health plan administration, claims administration or related legal matters.
• Experience reviewing administrative services agreements, provider network agreements, business associate agreements, or healthcare vendor agreements using approved templates or playbooks.
• Working knowledge of ERISA, HIPAA, COBRA, the Affordable Care Act, and federal and state requirements applicable to healthcare TPA operations.
• Working knowledge of self-funded plan designs, stop-loss insurance, claims appeals, grievances, and independent external review processes.
• Working knowledge of legal terminology, contract documentation, legal and regulatory research practices, and regulatory filing requirements.
• Ability to locate, review, summarize, and organize complex legal, regulatory, contractual, and claims-related information.
• Strong attention to detail with the ability to produce accurate work, identify inconsistencies, and follow matters through completion.
• Strong planning, organizational, and time management skills, with the ability to manage a high volume of work, competing priorities, and deadlines.
• Strong written and verbal communication skills and the ability to work effectively with attorneys, business partners, regulators, and external service providers.
• Ability to protect confidential, privileged, personal, and proprietary information and adhere to applicable data security requirements.
• Proficient skills in Microsoft Office, primarily Word and Excel, with the ability to learn and effectively use legal, document management, licensing, and other business systems.

WHY CHOOSE RELATION?

• Competitive pay.
• A safe and healthy work environment provided by our robust benefit program including family health and wellness programs, 401K, employee assistance programs, paid time off, paid holidays and more.  
• Career advancement and development opportunities.

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Note: The above is not all encompassing of the full position description. 

Relation Insurance Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

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