Crowell & Moring

International law firm; regulatory, IP, litigation

Health Insurance Claims Specialist

Claims AdjudicationConfirmed live in the last 24 hours

Full-time$76k - $140k

About the Job

Requirements

A bachelor's degree or an equivalent combination of education and experience is required.
A minimum of three years of experience in health care claims analysis, insurance claims, payor-provider disputes, or litigation support focused on managed care or regulatory compliance, or a related field, is required.
Prior experience at a law firm or insurance company handling health care litigation or audits.
Familiarity with health care insurance claims; payer-provider contracts; Medicare and Medicaid rules and regulations; and claims reimbursement frameworks.
Experience reviewing and interpreting large volumes of health care claims data, explanations of benefits, and denial codes.
Familiarity with Centers for Medicare & Medicaid Services manuals, coverage determinations, and medical necessity standards.
Understanding of sampling and extrapolation methodologies.
Strong written communication skills and ability to produce clear, concise, and structured claim summaries.
Attention to detail, critical thinking, and organizational skills.
Ability to work collaboratively with attorneys and clients to support litigation teams.

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 the 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 to ensure accurate and timely communication with legal teams and clients.
Synthesize information into actionable summaries to support legal analysis and trial strategy.

Desired Qualifications

Proficiency with Microsoft Office Suite and data-driven analysis tools, including document management systems, claims platforms, or litigation databases.

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 representing 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. At Crowell & Moring, exceptional client service begins with exceptional people. We are committed to delivering responsive, high-quality, and professional service to our clients and to one another, while continuously elevating standards of excellence across every aspect of our work.

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.

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 three (3) 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.

Pay Range

$81,000 - $120,000 - Boston, Chicago, Dallas, Denver, Los Angeles, Minneapolis, Orange County, Waltham, and Washington DC

$88,000 - $140,000 NY & SF

$76,000 - $120,000 Other US locations

#Remote

About the Company

Crowell & Moring

International law firm; regulatory, IP, litigation

Crowell & Moring is a global law firm with offices in the United States, Europe, the Middle East and North Africa (MENA), and Asia. It helps clients navigate regulatory and policy challenges, conduct litigation, close transactions, and protect intellectual property by drawing on experience from government, business, industry, and legal practice. Services are delivered through coordinated teams that advise on complex issues and provide creative, practical solutions. The firm distinguishes itself with a strong commitment to pro bono work and programs that support the professional and personal development of all members. The goal is to help clients seize opportunities while managing risk, so they can operate smoothly in a worldwide regulatory environment.

Company size: 1,001-5,000
Company stage: Not listed
Total funding: Not listed
Headquarters: United States
Founded: 1979

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