Health Insurance Specialist

Role Overview

• Claims & Insurance Follow-Up: Open claims with Medi-Cal, Medicare, VA, medical groups, and commercial insurance providers for personal injury cases.
• Monitor and resolve claim-related issues to ensure timely collection of documentation.
• Maintain ongoing follow-up with all applicable insurance providers until every lien is fully resolved at the time of case settlement or closure.
• Communicate with insurance carriers to verify treatment details, payments, and claim status.
• Lien Review & Dispute Support: Thoroughly review medical bills and verify health insurance liens against treatment records and payments.
• Identify discrepancies, invalid charges, or missing information.
• File disputes to add or remove charges as needed.
• Review medical records and bills in the file to support dispute submissions.
• Case Coordination & Internal Support: Coordinate with the case management team to obtain missing reports, invoices, or documentation.
• Collaborate with attorney teams to ensure tasks are handled accurately and on time.
• Serve as the primary point of contact for health insurance-related inquiries across the firm.
• Provide guidance to team members on complex lien-related issues.
• Client & Administrative Support: Engage clients to gather required details or documents when necessary.
• Maintain accurate records, documentation, and case updates.
• Perform other related duties as assigned.

Requirements

• Previous experience in health insurance, medical liens, claims, billing, or personal injury case support preferred.
• Familiarity with Medi-Cal, Medicare, VA, medical groups, or commercial insurance providers is a strong plus.
• Strong attention to detail and ability to review medical bills, treatment records, and payment information accurately.
• Excellent organizational and follow-up skills.
• Strong written and verbal communication skills in English.
• Ability to work independently in a remote environment.
• Comfortable handling confidential and sensitive case information.
• Ability to collaborate with case managers, attorneys, insurance providers, and clients.