Insurance Defense - General Attorney in Cleveland, OH

In-House

Cleveland, OH

Insurance Defense - General Attorney in Cleveland, OH

Attorney

Min 2 yrs required

No

Job Title: Assistant Claims Counsel (Remote)

Job Responsibilities:
The Assistant Claims Counsel at the company is tasked with supporting the team to deliver high-quality service to participating law firms and members utilizing their legal plans. Key responsibilities include:

- Reviewing claims to ensure timely and accurate approval and payment in compliance with Service Level Agreements (SLAs) and company expectations.
- Evaluating billing inquiries to determine claim approval and payment or if additional information is needed from attorneys or participants.
- Identifying billing issues with network providers to be addressed by the Attorney Network Team.
- Assisting in the review of fee reimbursement claims to ensure proper approval and payment, seeking additional information from members if necessary in compliance with SLAs.
- Providing legal support to the claims team for claims involving legal questions.
- Advising and guiding the Claims and Panel Teams on questions and concerns from participating law firms and plan participants, handling escalated complaints as needed.
- Reviewing and responding to fee reimbursement appeals in compliance with company SLAs, including drafting correspondence to participants, attorneys, regulatory agencies, and others as applicable.
- Serving as a resource for other departments on claims and coverage issues.
- Assisting with audits and drafting legal policies and procedures.
- Participating in training and refresher courses.
- Obtaining and maintaining all necessary adjuster licenses.
- Performing other duties as required or assigned.

Education and Experience Information:
- A Bachelor’s degree from an accredited university.
- A . from an accredited law school.
- At least 2 years of experience as a practicing attorney.
- Proficiency with Microsoft Office products including Teams, Excel, Outlook, and PowerPoint.
- High level of confidentiality for handling sensitive situations and documentation.
- Effective communication skills with attorneys and customers about sensitive legal matters.
- Strong work ethic with the ability to self-start, prioritize, and manage a high-volume workload.

Ideal Qualifications:
- Demonstrated success as a leader who fosters a culture of empowerment, development, ownership, and accountability.
- Experience in the claims review and approval process.
- Ability to analyze and solve problems, perform complex tasks, and prioritize independently.
- Skills to analyze fee, legal, and coverage issues, and identify/differentiate legal matters.
- Ability to adapt and grow with the company as coverage and legal matters evolve.
- Positive, motivating attitude and flexibility.

What Will Make You Special:
- Broad experience and/or comprehensive knowledge of the practice of law.
- Licensure as a Claims Adjuster.

Attributes/Personal Characteristics:
- Ability to prioritize and execute project plans.
- Flexible and adaptable to an ever-changing business environment.
- Disciplined in nature.
- Attention to detail.
- Strong get-it-done mentality.
- Punctual, reliable, and trustworthy.
- Excellent time management skills.

Salary Information:
The text does not provide specific salary information for this position.

Additional Information:
Travel requirements for this position are up to 5%. The job description notes that duties may be modified to accommodate individuals with disabilities and that the role operates within an “at-will” employment relationship. The requirements and responsibilities listed are the minimum levels needed to successfully perform the job.