Talent.com
Health Care Claims Specialist

Health Care Claims Specialist

Crowell & MoringChicago, IL, US
job_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

Health Care Claims Specialist

Crowell & Moring LLP is an international law firm with offices in the United States, Europe, MENA, and Asia that represents clients in litigation and arbitration, regulatory and policy, intellectual property, and transactional and corporate matters. The firm is internationally recognized for its representation of Fortune 500 companies in high-stakes litigation and government-facing matters, as well as its ongoing commitment to pro bono service and diversity, equity, and inclusion.

Job Summary

The Health Care Claims Analyst 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.

This role can be based in any of Crowell's office locations.

Job Responsibilities

  • 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.
  • Evaluate merits and potential liability of claim batches to assess applicability to claims in dispute.
  • Review claim analysis and data from clients to validate findings, identify legal and factual issues, and support or challenge conclusions.
  • Maintain case summaries, claim trackers and databases ensuring accurate and timely communication with legal teams and clients.
  • Synthesize information into actionable summaries to support legal analysis and trial strategy.

Knowledge, Skills and Abilities

  • Familiarity with health care insurance claims and strong working knowledge of payer-provider contracts, Medicare / Medicaid rules and regulations, and claims reimbursement frameworks
  • Experience reviewing and interpreting large volumes of healthcare claims data, EOBs, and denial codes
  • Strong written communication skills and ability to produce clear, concise and structured claim summaries.
  • Excellent attention to detail, critical thinking and organizational skills
  • Proficiency with MS Suite and data driven analysis tools including document management systems, claims platforms, or litigation databases preferred.
  • Ability to work collaboratively with attorneys and clients to provide support to litigation teams
  • Education

  • The position requires a bachelor's degree or equivalent combination of education and experience.
  • Experience

  • The position requires a minimum of five (5) years of experience in health care claims analysis, insurance claims, payor-provider disputes, or litigation support with focus on managed care or regulatory compliance, or related field.
  • 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
  • Crowell & Moring LLP offers a competitive compensation and comprehensive benefits package. Our benefits include healthcare, vision, dental, retirement, and all-purpose leave and progressive options such as back up childcare, wellness programs, cultural events and social activities. We take great pride in our positive, friendly culture that rewards hard work and success, at the same time recognizing the importance of family and community service.

    Our Firm is committed to fair and equitable compensation practice in accordance with applicable laws. The salary range for this position is $78,000-$103,000. Additional compensation may include a discretionary bonus. The salary for this position may vary based on location, market data, an applicant's skills and prior experience, certain degrees and certifications, and other factors.

    EOE m / f / d / v Crowell & Moring LLP participates in the E-Verify program.

    serp_jobs.job_alerts.create_a_job

    Health Care Specialist • Chicago, IL, US

    Job_description.internal_linking.related_jobs
    • serp_jobs.job_card.promoted
    Senior Claims Specialist

    Senior Claims Specialist

    Insight GlobalDowners Grove, IL, US
    serp_jobs.job_card.full_time
    Insight Global is looking for a Claims Specialist to join a third-party workers compensation organization headquartered in Chicago, IL. The Claims Specialist manages within company standards and bes...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    Insurance Claims Collection Specialist (Hybrid Role)

    Insurance Claims Collection Specialist (Hybrid Role)

    Romexterra ConstructionAddison, IL, USA
    serp_jobs.job_card.full_time
    serp_jobs.filters_job_card.quick_apply
    Insurance Claims Collection Specialist.This position requires strong communication skills, attention to detail, and the ability to resolve claim discrepancies with insurance providers.Bilingual pro...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Senior Technical Claims Specialist - Rideshare Commerical Claims Complex Injury

    Senior Technical Claims Specialist - Rideshare Commerical Claims Complex Injury

    Liberty Mutual Insurance GroupHoffman Estates, IL, US
    serp_jobs.job_card.full_time
    Senior Technical Claims Specialist.Are you a seasoned claims professional looking to make a bigger impact? Join Liberty Mutual as a Senior Technical Claims Specialist, and take ownership of complex...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Remote Disability Claims Specialist

    Remote Disability Claims Specialist

    Axelon Services CorporationHometown, IL, US
    serp_jobs.filters.remote
    serp_jobs.job_card.full_time
    Disability Claims Specialist MAX PAY RATE - $42 per hour Fully Remote 10-20 hours per week Must have at least 3+ years prior LTD / IDI Insurance Claims Experience At • • •, we seek to make a meaningful...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    AR Insurance Follow-Up Specialist

    AR Insurance Follow-Up Specialist

    The LaSalle NetworkSchaumburg, IL, US
    serp_jobs.job_card.full_time
    AR Insurance Follow-Up Specialist.LaSalle Network is partnering with a healthcare organization in Schaumburg, IL, seeking an experienced AR Insurance Follow-Up Specialist to join their growing team...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Complex Claims Specialist

    Complex Claims Specialist

    HiscoxChicago, IL, US
    serp_jobs.job_card.full_time
    Individual contributor role responsible for the handling of Miscellaneous Professional Liability claims for the organization from inception to resolution. This involves the negotiation and settlemen...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Senior Claims Examiner, Professional Liability

    Senior Claims Examiner, Professional Liability

    MarkelChicago, IL, US
    serp_jobs.job_card.full_time
    What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it.The work we do at Markel gives people the confidence to move forward and seize opp...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    Casualty Claims Associate

    Casualty Claims Associate

    First Chicago Insurance Company (FCIC)Bedford Park, IL, USA
    serp_jobs.job_card.full_time
    serp_jobs.filters_job_card.quick_apply
    We are seeking the ideal candidate for our Casualty Claims Associate opening for our growing Auto insurance company!.The Claims Associate will be responsible for assisting the Claims Department in ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Senior Technical Claims Specialist, Energy Complex

    Senior Technical Claims Specialist, Energy Complex

    Liberty Mutual Insurance GroupHoffman Estates, IL, US
    serp_jobs.job_card.full_time
    Senior Technical Claims Specialist.Liberty Mutual has an immediate opening for a Senior Technical Claims Specialist to join our Energy Complex Team. The Senior Technical Claims Specialist determines...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Management Liability Claims Specialist

    Management Liability Claims Specialist

    IAT Insurance GroupRolling Meadows, IL, US
    serp_jobs.job_card.full_time
    Management Liability Claims Specialist.IAT Insurance Group has an immediate opening for a Management Liability Claims Specialist that can be located in any of our IAT locations.This role works a hy...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Claims Appeals Specialist

    Claims Appeals Specialist

    ChubbChicago, IL, US
    serp_jobs.job_card.full_time
    Focus on the core content of the job post, removing any extra metadata, navigation mentions, and redundant headers.Keep the content beautiful and high signal to noise ratio.serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Senior Claims Specialist, Financial Lines Management Liability

    Senior Claims Specialist, Financial Lines Management Liability

    Liberty Mutual Insurance GroupHoffman Estates, IL, US
    serp_jobs.job_card.full_time
    Senior Claims Specialist, Financial Lines Management Liability.Liberty Mutual has an immediate opening for a Senior Claims Specialist, Financial Lines Management Liability position.In this role, wi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    Casualty Claims Associate

    Casualty Claims Associate

    Warrior Insurance NetworkBedford Park, IL, USA
    serp_jobs.job_card.full_time
    serp_jobs.filters_job_card.quick_apply
    We are seeking the ideal candidate for our Casualty Claims Associate opening for our growing Auto insurance company!.The Claims Associate will be responsible for assisting the Claims Department in ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Liability Claims Specialist

    Liability Claims Specialist

    CorVelDowners Grove, IL, US
    serp_jobs.job_card.full_time
    The Liability Claims Specialist manages within company best practices lower-level, non-complex and non-problematic liability claims within delegated limited authority to best possible outcome, unde...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Senior Claims Specialist

    Senior Claims Specialist

    CorVelDowners Grove, IL, US
    serp_jobs.job_card.full_time
    The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determin...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Senior Liability Claims Specialist

    Senior Liability Claims Specialist

    CorVelDowners Grove, IL, US
    serp_jobs.job_card.full_time
    Senior Liability Claims Specialist.CorVel is seeking a Senior Liability Claims Specialist.The Senior Liability Claims Specialist manages within company best practices complex and non-complex Auto a...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Medical Claims Review Representative

    Medical Claims Review Representative

    Midwest Orthopaedic ConsultantsOrland Park, IL, US
    serp_jobs.job_card.full_time
    Medical Claims Review Representative.To ensure that all charges, claims and / or vouchers have been accurately submitted to the appropriate payers in a timely manner and that complete and accurate pa...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Associate Claims Representative

    Associate Claims Representative

    CNADowners Grove, IL, US
    serp_jobs.job_card.full_time
    You have a clear vision of where your career can go.And we have the leadership to help you get there.At CNA, we strive to create a culture in which people know they matter and are part of something...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days