TEMP-Senior Medical Pricing Specialist

Argo Group is an underwriter of specialty insurance products in the property and casualty market, offering a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses.

About the role

We are looking for a highly capable Senior Medical Pricing Specialist to help us on a temporary assignment with an estimated end date. This role can be performed in-office or remotely from anywhere in the United States. The Senior Medical Pricing Specialist oversees and coordinates the accurate processing of medical payments for Workers’ Compensation (WC) claims in accordance with applicable state fee schedules, ensuring payment accuracy, vendor compliance, and efficient bill review processes while serving as a key resource for claim staff and internal stakeholders.

As this is a temporary assignment, only government-mandated benefits will be provided. Contractors must accurately record all hours worked and submit timesheets in accordance with company policy. Overtime may be assigned as business needs dictate.

Responsibilities

• Oversee, manage, and coordinate the end-to-end processing of medical payments for WC claims in compliance with state fee schedules and regulatory requirements.
• Audit and monitor bill review vendors to ensure accuracy, compliance, and adherence to contractual standards.
• Collaborate with Claims staff to optimize medical bill processing workflows and resolve discrepancies.
• Evaluate and reconcile daily EDI transactions for both individual and bulk medical bill payments.
• Review daily reports and Explanation of Review (EOR) documentation to verify accuracy, including Federal Tax IDs, duplicate payments, and potential errors.
• Investigate and resolve billing discrepancies, duplicate charges, and payment inconsistencies.
• Maintain accurate data entry and reporting within systems such as Web-TDS.
• Respond to medical bill inquiries and provide timely, accurate guidance to internal and external stakeholders.
• Submit reconsideration requests electronically to bill review vendors as needed.
• Support continuous process improvement efforts to enhance efficiency and payment accuracy.
• Perform additional duties as assigned.

Requirements

• A minimum of 2 years of experience in medical billing, medical pricing, or Workers’ Compensation claims processing.
• Bachelor’s degree from an accredited university required, or four additional years of related experience beyond the minimum experience required.
• Practical knowledge of medical terms, procedures, and management, as well as the litigation process.
• Good business acumen, including an understanding of how an insurance company operates and makes money, and how this role impacts profitability for both Argo Group and its customers.
• Excellent communication skills and the ability to build lasting relationships.
• Strong focus on execution, with a proven ability to consistently produce and deliver expected results to all stakeholders.
• Solution-focused mindset, with the ability to find success through adversity and think with a global perspective.
• Flexibility, resourcefulness, and the ability to thrive in a fast-paced, constantly evolving environment.
• Excellent evaluation and strategic skills.
• Strong customer focus and effective time management skills, with the ability to prioritize workload while handling multiple tasks and deadlines.
• Ability to work independently and exercise sound judgment.
• Demonstrated integrity, courage, and commitment to doing the right thing daily.
• Intellectual curiosity, with a willingness to explore all options and challenge conventional thinking.
• Proficiency in MS Office Suite and other business-related software.
• Polished and professional written and verbal communication skills, with fluency in English.
• Desire for continued professional development through continuing education and self-development opportunities.

Pay

The base hourly pay range varies by location as follows:

• Colorado (outside of Denver metro), Delaware, Illinois (outside of Chicago metro area), Maine, Maryland, Massachusetts (outside of Boston metro area), Minnesota, Nevada, Rhode Island, Vermont, and Virginia: $37.66 – $44.33 per hour.
• Boston metro area, California (outside of Los Angeles & San Francisco metro area), Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D.C. metro area, and Washington State: $41.44 – $48.79 per hour.
• New York City, Los Angeles, and San Francisco metro areas: $45.16 – $53.16 per hour.

In addition to base salary, this position is eligible for an annual bonus based on company and individual performance.

About Working in Claims at Argo Group

Argo Group values its claims professionals and offers challenging, diverse, and impactful work. Adjusters and Managers are empowered to exercise independent discretion and creativity in developing solutions for unique cases. The organization has a flat structure, fostering collaboration and interaction with senior management, particularly for large losses. The claims team works together to resolve claims efficiently, with a focus on innovation and employee input. Argo Group is committed to building an inclusive and diverse team and encourages applications from all backgrounds.

Applicants must be legally authorized to work in the United States. At this time, sponsorship for employment visas is not available.