Health Care Claims Specialist

Job Description

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.

Qualifications

Requirements :

Knowledge, Skills and Abilities

Education

Experience