Health Insurance Claims Specialist
Job Summary
Supporting attorneys in legal analysis, the full-time Health Insurance Claims Specialist will review claim files, compile factual summaries, and identify key documents while working remotely or from various office locations.
Key responsibilities
- Review and analyze healthcare claim files involved in payor/provider disputes to identify patterns and administrative issues
- Evaluate merits and potential liability of claim batches to assess applicability to claims in dispute
- Synthesize information into actionable summaries to support legal analysis and trial strategy
Required qualifications
- Bachelor's degree or equivalent combination of education and experience
- Minimum of three years of experience in health care claims analysis or related field
- Familiarity with health care insurance claims and payer-provider contracts
- Prior experience at a law firm or insurance company handling health care litigation or audits
- Understanding of sampling and extrapolation methodologies
Complete Job Description
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