Health Insurance Specialist

About the role

The Health Insurance Specialist helps the firm resolve client medical liens efficiently and accurately. The role opens, manages and resolves health insurance claims with Medi-Cal, Medicare, the VA and commercial providers, keeping billing records, treatment documentation and case strategy aligned. It suits a proactive, detail-oriented person who can communicate well with internal teams and external parties.

Key responsibilities

• Open claims with Medi-Cal, Medicare, VA, medical groups and commercial insurers for personal injury cases.
• Monitor and resolve claim issues so documentation is collected on time.
• Review medical bills and verify health insurance liens against treatment records and payments.
• Identify and address discrepancies or invalid charges, file disputes and add or remove charges as needed.
• Coordinate with the case management team to obtain missing reports or invoices for dispute submissions.
• Guide team members on challenging lien-related issues and act as the main contact for health insurance questions.
• Communicate with insurance carriers and coordinate with case management to verify treatment details and payments.
• Work with attorney teams to keep tasks accurate and on time, and engage clients to gather required details or documents.
• Maintain follow-up with insurance providers until every lien is resolved at case settlement or closure.

Required profile

• 2+ years of experience handling health insurance claims, medical liens or healthcare reimbursement processes.
• Strong knowledge of Medicare, Medi-Cal, VA benefits and commercial health insurance providers.
• Experience in a personal injury law firm is strongly preferred.
• Ability to work independently while collaborating with a dynamic team.

Required skills

• Proficiency with case management systems, Microsoft Office and document management platforms.
• Strong organizational skills to manage multiple cases and deadlines.
• Excellent written and verbal communication with clients, providers, carriers and internal teams.