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Health Insurance Claims Specialist
4 days agoWhat's your preference?
Job Description
- Req#: 744000108814841
Employer Industry: International Law Firm
Why consider this job opportunity:
- Salary up to $119,000
- Additional compensation may include a discretionary bonus
- Comprehensive benefits package including healthcare, vision, dental, and retirement options
- Flexible work environment with the option to work fully remote or from any office location
- Positive and friendly company culture that values hard work and community service
- Opportunities for professional growth and development within a prestigious firm
What to Expect (Job Responsibilities):
- Review and analyze health care claim files involved in payor/provider disputes, identifying patterns and administrative issues
- Evaluate merits and potential liability of claim batches related to claims in dispute
- Review claim analysis and data from clients to validate findings and support or challenge conclusions
- Maintain case summaries, claim trackers, and databases ensuring accurate communication with legal teams and clients
- Synthesize information into actionable summaries to support legal analysis and trial strategy
What is Required (Qualifications):
- Minimum education requirement: Bachelor's degree or equivalent combination of education and experience
- Minimum of three (3) years of experience in health care claims analysis, insurance claims, payor-provider disputes, or litigation support
- Familiarity with health care insurance claims and knowledge of payer-provider contracts, Medicare/Medicaid regulations, and claims reimbursement frameworks
- Strong written communication skills and ability to produce clear, concise claim summaries
- Proficiency with MS Suite and data-driven analysis tools, including document management systems or litigation databases
How to Stand Out (Preferred Qualifications):
- Prior experience at a law firm or insurance company handling health care litigation or audits
- Familiarity with CMS manuals, coverage determinations, and medical necessity standards
- Understanding of sampling and extrapolation methodologies
#InternationalLaw #HealthInsuranceClaims #LegalAnalysis #CareerOpportunity #RemoteWork
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