Senior Appeals Case Manager

  • Full Time
  • Chicago

Website DeBofsky Sherman Casciari Reynolds P.C.

We are a boutique law firm located in downtown Chicago. Our practice is concentrated on representing individuals in insurance and other employee benefits-related claims. Most of the claims relate to disability or health insurance and can involve complex medical issues. In addition, most of our cases fall into one of two stages – (1) the claims submission and appeals stage, where we are working with the insurance company directly, and (2) litigation in court if/when the claims/appeals are denied. We currently have 5 full-time attorneys and 6 administrative staff members. We are looking to hire one more full-time employee to manage, coordinate, and monitor all the firm’s pre-litigation insurance claims and appeals.

The candidate must have prior administrative experience with client contact and some background in reviewing and understanding medical records. Prior experience with health or disability insurance, workers’ compensation, personal injury, or Social Security disability benefits claims is preferred. Nurse training or licensure is a plus, but not required. Compensation for this position starts at $65,000+, commensurate with experience, along with full benefits (including health insurance, life insurance, disability insurance, 401k benefits, profit sharing, parental leave, and paid time-off).

Responsibilities include:

– Working independently of the attorneys while managing supporting administrative staff

– Docketing deadlines and assigning tasks to administrative staff, and supervising them to ensure task completion

– Maintaining, organizing, and preparing client files and information in a cloud-based database

– Maintaining follow-up communications with clients regarding their medical treatment history and providing status updates regarding their claims/appeals

– Obtaining client medical records and coordinating specialized medical evaluations, testing, and completion of questionnaires when needed

– Compiling client medical records and coordinating the preparation of written summaries of such records for submission to insurance companies

– Corresponding with insurance companies over the phone and via written correspondence

– Reviewing, analyzing, and organizing insurance claim files, and making recommendations regarding the additional evidence needed to perfect the pre-suit appeal

The ability to work independently, multi-task, be organized, and meet strict deadlines are all a must. If interested, please submit a resume and cover letter, along with wage requirements. Finalists must be prepared to provide references and writing samples.

*DeBofsky Sherman Casciari Reynolds P.C. is an equal opportunity employer.

Job Type: Full-time

Salary: $65,000 + per year

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