Health Insurance Claims Specialist

Crowell & Moring LLP

Remote
Base: $83,000 - $108,000 (most us); $87,000 - $119...
Remote
Health care insurance claims
Payer-provider contracts
Medicare/medicaid rules
Crowell & Moring LLP is seeking a Health Insurance Claims Specialist to support attorneys by reviewing and analyzing healthcare claim files, focusing on payor/provider disputes. The ideal candidate should possess a strong knowledge of health care insurance claims and relevant experience in claims analysis or litigation support

Job Summary

  • The Health Insurance Claims Specialist role will support attorneys by reviewing claim files, compiling factual summaries, identifying key documents and facilitating legal analysis regarding liability, potential defenses, exposure valuations, and settlement strategies.
  • Review and analyze health care claim files involved in payor/provider disputes, identifying patterns and administrative issues such as coding errors, denial reasons, and medical necessity claims.
  • Crowell & Moring LLP offers a competitive compensation and comprehensive benefits package, including healthcare, vision, dental, retirement, and all-purpose leave.

Matching Summary

Match Score: 85

Crowell & Moring LLP is seeking a Health Insurance Claims Specialist to support attorneys by reviewing and analyzing healthcare claim files, focusing on payor/provider disputes. The ideal candidate should possess a strong knowledge of health care insurance claims and relevant experience in claims analysis or litigation support.

Salary

Base: $83,000 - $108,000 (Most US); $87,000 - $119,000 (NY & SF); $78,000 - $103,000 (Other US); Bonus/Equity: Discretionary bonus; Benefits: Healthcare, vision, dental, retirement, all-purpose leave

Skills & Requirements

Must-have

  • health care insurance claims
  • payer-provider contracts
  • Medicare/Medicaid rules
  • claims reimbursement frameworks
  • healthcare claims data
  • EOBs and denial codes
  • document management systems

Nice-to-have

  • litigation support experience
  • managed care focus
  • regulatory compliance focus
  • CMS manuals familiarity
  • sampling and extrapolation methodologies

Key Requirements

  • Bachelor's degree or equivalent
  • Minimum 3 years experience
  • Experience in health care claims analysis
  • Experience in insurance claims
  • Experience in payor-provider disputes
  • Experience in litigation support
  • Experience at law firm or insurance company

Work Rights

Not specified

Tailored Resume

Cover Letter