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Crowell & Moring · 1 day ago

Healthcare Paralegal Specialist

1001 Pennsylvania Ave NW, Washington, DC 20004, USA

Full-time

Onsite

Mid, Senior Level

$83K/yr - $108K/yr

5+ years exp

Crowell & Moring LLP is an international law firm that represents clients in various legal matters. The Healthcare Paralegal Specialist role will support attorneys by reviewing claim files, compiling factual summaries, and facilitating legal analysis regarding liability and settlement strategies.

ConsultingLegal

H1B Sponsor Likely

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

Qualification

Healthcare claims analysisPayer-provider contractsMedicare/Medicaid regulationsData analysis toolsClaims reimbursement frameworksEOBs interpretationDenial codes analysisCMS manuals familiaritySampling methodologiesWritten communicationAttention to detailCritical thinkingOrganizational skillsCollaborative work

Required

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

The position requires a bachelor's degree or equivalent combination of education and 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

Benefits

Healthcare

Vision

Dental

Retirement

All-purpose leave

Back up childcare

Wellness programs

Cultural events

Social activities

Company

Crowell & Moring

Crowell & Moring is an international law firm headquartered in Washington, D.C.

Founded in 1979

Washington, District of Columbia, USA

1001-5000 employees

http://www.crowell.com

H1B Sponsorship

Crowell & Moring has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (3)

2024 (4)

2023 (3)

2022 (1)

2021 (2)

2020 (1)