Insurance Appeals Specialist

About the Role

Fisher Phillips, a premier international labor and employment law firm, is seeking an Insurance Appeals Specialist to join the 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 from any location within the United States where Fisher Phillips currently maintains an established office, and reports to the EPLI Project Manager.

Responsibilities

• 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.
• 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.
• 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.
• Perform additional duties and responsibilities as assigned, with requirements that may vary from time to time.

Requirements

• 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.
• 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).
• Exceptional written, verbal, and interpersonal communication skills with a proven ability to build effective working relationships with internal and external personnel at all levels.
• 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.
• Ability and willingness to travel to firm offices and other events as needed.

Preferred Qualifications

• 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

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.

Benefits

• Health, dental, and vision insurance
• 401(k) with profit sharing
• 18 days of vacation per benefit year
• 10 sick days accrued each calendar year
• 10 paid holidays per benefit year
• Wellness programs
• 24/7 telehealth services