Insurance Appeals Specialist

Fisher Phillips; United States; Remote; USD 66.000 - 79.000; Vollzeit

Zusammenfassung

Fisher Phillips is seeking an Insurance Appeals Specialist to join the Legal Project Management Team. This role focuses on managing, researching, interpreting, and drafting timely, Billing Guideline-compliant responses to deductions by insurance companies on defense counsel invoices.

The successful candidate will have strong experience in employment law, legal bill review, and familiarity with Defense Counsel Billing Guidelines.

Qualifikationen

• Bachelor’s degree plus at least 5 years of legal bill review or insurance defense experience.
• Experience with Defense Counsel Billing Guidelines and insurance billing guidelines.
• Strong communication skills with attorneys and firm management.
• Ability to handle confidential matters with discretion and manage multiple projects.

Aufgaben

• Oversee EPLI appeals and understand each insurance company’s Defense Counsel Billing Guidelines.
• Review, research, and draft timely, compliant appeal responses for deductions.
• Draft persuasive responses and communicate with timekeepers for additional detail.
• Partner with Billing and Collections to submit appeals on time.
• Develop strategies to improve guidelines-compliant entries and reduce reductions.
• Monitor outcomes and provide leadership with appeal results and staffing needs.

Kenntnisse

Legal bill review

Insurance defense

Communication

Ausbildung

Bachelor’s degree

Five years experience

Tools

BillBlast

Aderant

Legal Tracker

Tymetrix 360

Microsoft Office

Jobbeschreibung

Full-Time, Remote (Eligible in U.S. jurisdictions with an existing Fisher Phillips office) Fisher Phillips, a premier international labor and employment law firm, is seeking an Insurance Appeals Specialist to join our Legal Project Management Team. This role is responsible for managing, researching, interpreting, and drafting timely and Billing Guideline-compliant responses to deductions taken by insurance companies on defense counsel invoices.

The successful candidate will have experience with employment law, legal bill review, a strong understanding of insurance Defense Counsel Billing Guidelines, and the ability to professionally communicate with attorneys to develop strong working relationships and credibility with firm management, leaders, attorneys, and administrative departments across the firm.

This position can be performed on a fully remote basis and reports to the EPLI Project Manager.

Key Responsibilities

Working primarily with the Director of Legal Project Management, EPLI Project Manager, and Billing and Collections Team, this individual will manage the process for reviewing, researching, and preparing timely and successful appeal responses including, but not limited to, the following responsibilities:

Oversight of EPLI Appeals

• Develop a thorough understanding of each insurance company’s Defense Counsel Billing Guidelines.
• Review, assess, and research insurance billing deductions using matter files and Defense Counsel Billing Guidelines to determine appealability.
• Draft a persuasive, compliant, and well-written response to each reduction.
• Communicate professionally, effectively, and proactively with impacted timekeepers regarding reduced entries that need additional detail that could not be obtained from the matter file.
• Partner with the Billing and Collections team to timely submit the appeals responses to the insurance companies.
• Develop and implement strategies to improve Guidelines-compliant entries and reduce reductions.
• Monitor the outcomes of submitted appeals to fortify and improve subsequent draft responses.

Operational Strategy & Reporting

• Work with the Director of Legal Project Management and EPLI Project Manager to establish financial and other performance goals.
• Track the outcomes of submitted appeals to determine the amount credited versus appealed and the number of successfully appealed time entries.
• Provide reports to leadership regarding appeal results, staffing needs, and other information as needed.

Interdepartmental Collaboration

• Collaborate with Legal Project Management, Knowledge Management, Billing and Collections, and Information Technology to implement AI or other technology solutions that create efficiencies or otherwise improve outcomes.

Qualifications

Required

• Education & Experience: Bachelor’s degree and at least 5 years of experience in legal bill review or insurance defense work, including prior experience as an attorney or paralegal at a large law firm or major insurance company.
• Technical Expertise: Deep understanding of defense counsel activities, legal terminology, and insurance company Defense Counsel Billing Guidelines; proficiency in legal billing software (BillBlast, Aderant), eBilling vendors (Legal Tracker, Tymetrix 360), and Microsoft Office applications (Word, Outlook, PowerPoint, Excel).
• Communication & Interpersonal Skills: Exceptional written, verbal, and interpersonal communication skills with a proven ability to build effective working relationships with internal and external personnel at all levels.
• Core Competencies: Superior judgment, discretion, and commitment to handling sensitive, confidential matters professionally; highly organized with the ability to manage multiple projects, prioritize assignments, and work both independently and collaboratively.
• Flexibility: Ability and willingness to travel to firm offices and other events as needed.

Preferred

• Juris Doctor (JD) degree.
• Specific experience defending labor and employment matters.
• Familiarity with the operational structure of large, multi-office litigation law firms.
• Demonstrated commitment to diversity, equity, and inclusion in legal staffing.

Compensation

This position can be performed on a fully remote basis from any location within the United States where Fisher Phillips currently maintains an established office. The hourly range for this position is $48.08 - $57.69. Actual base pay within this range will be determined by several components, including but not limited to, location, relevant experience, internal equity, skills, qualifications, and other job-related factors permitted by law.

Qualified applications with arrest or conviction records will be considered for employment in accordance with both the FCO and the California Fair Chance Act (FCA).

Equal Opportunity Employer

Fisher Phillips is committed to providing equal employment opportunities to all employees and applicants, regardless of race, ethnicity, religion, sex (including related medical conditions), gender, sexual orientation, national origin, citizenship status, veteran status, marital status, pregnancy, age, disability, or any other protected status, in compliance with all applicable laws.

Why Join Us

At Fisher Phillips, exceptional talent is the foundation of our success. Joining our team means collaborating in a professional, dynamic environment leveraging cutting-edge technology. Our leadership fosters professional growth and provides opportunities to challenge yourself.

Our comprehensive benefits include health, dental, and vision insurance, a 401(k) with profit sharing, 18 days of vacation, accrue 10 sick days each calendar year and 10 paid holidays per benefit year. Wellness programs and 24/7 telehealth services support your overall well-being. Visit www.fisherphillips.com to learn more.

Additional Notes

The statements in this position description are not necessarily all-inclusive. Additional duties and responsibilities may be assigned, and requirements may vary from time to time.

As part of our initial screening process, we may use an AI tool to compare the skills and job titles from your resume with the job description, using machine learning or artificial intelligence based on their contextual meaning and relevancy. This is NOT an automated employment decision tool (‘AEDT’) and will not be used to make selection decisions. It is only used (occasionally) in addition to manual screening.

If you are a resident of New York City and would like to request an alternative evaluation process or reasonable accommodation, please email [e-mail].

Relocation costs are not covered. We are only accepting direct applicants; third-party recruiters or agencies will not be considered. No phone inquiries, please.