Job Summary

A health insurance company needs applicants for an opening for a Remote Legal Services Specialist.

Core Responsibilities of this position include:

• Supporting the Litigation Team by providing operational research for legal defense of provider and member disputes
• Identifying the underlying processes, procedures, applications and/or systems used or connected with claims adjudication
• Retrieving the related documents to create an administrative record

Required Skills:

• 4+ years of experience in consumer affairs, customer service and/or claim operations
• Proficient in use of ISET, CDB and DOC360
• Proficient in Microsoft Word, Excel and Adobe Acrobat
• Claim review and/or adjudication experience on any of these claim platforms: Unet, COSMOS, FACETS or Cirrus