Claims Verification Case Manager (Contractor)

POSITION SUMMARY

The Claims Verification Case Manager is a case-development professional whose mission is to maximize case value, improve the client experience, and deliver attorney-ready files. This role acts as the bridge between matter intake and our legal teams, managing file setup, coverage investigation, liability investigation, client communication, and overall case readiness while ensuring assigned personal injury matters are accurate, complete, and positioned to move forward without avoidable delay.

This remote role works closely with the U.S.-based Claims Verification and Legal Support teams. It requires strong written English, disciplined follow-up, careful handling of confidential records, and consistent overlap with Louisiana business hours.

KEY RESPONSIBILITIES

File Setup and Development

• Review new assigned cases for completeness and accuracy.

• Verify critical intake information and identify missing documentation.

• Ensure the case is properly established in the case-management system and AI platform.

Coverage and Liability Investigation

• Confirm available insurance details for missing, inconsistent, or incomplete information

• Open appropriate claims

• Draft and transmit claims related documents

• Request and obtain coverage documentation, police reports, photographs, statements, and other available coverage and liability evidence

• Identify and flag liability and coverage issues and gaps

• Escalate discrepancies, suspected errors, urgent deadlines, and matters requiring legal judgment

Client Communication

• Complete required early-stage and milestone communications

• Explain the claims verification process and immediate next steps to clients.

• Maintain trust and engagement while the case is being developed.

Records and Document Coordination

• Request, retrieve, label, and organize medical, billing, insurance, and other claim-related records as assigned

• Maintain complete and accurate electronic files and document request histories

• Follow up with carriers, providers, vendors, and internal case teams using approved procedures

• Confirm documents are attached to the correct matter and routed for appropriate review

Workflow, Quality and Team Support

• Maintain timely updates in the firm’s designated case management system

• Prepare timely, accurate, and concise case notes, tasks, and status notes Support process checklists, quality reviews, and handoffs to case managers and paralegals

• Follow approved service levels for response times, follow-up intervals, and record completeness

Confidentiality and Scope

• Safeguard client and medical information using approved firm systems and access controls

• Follow attorney supervision, confidentiality, and data security requirements

• Do not independently offer legal advice, negotiate claims, or make legal determinations

QUALIFICATIONS AND EXPERIENCE

Required

• 1+ years in legal support, insurance claims, case management, or a similarly detail-heavy role

• Strong investigative judgement and effectiveness in identifying missing information.

• Professional, clear, and compassionate written and spoken English and comfort communicating with U.S.-based teams, providers, and clients.

• Exceptional document handling, task tracking, and electronic file organization skills

• Reliable internet connection, quiet workspace, and agreed U.S. business-hour availability

• Excellent accuracy, discretion, follow-through, and ability to identify issues promptly

• Comfort working in a fast-paced, technology-enabled, process-driven environment.

• Ability to manage parallel workstreams while meeting deadlines and quality standards.

• Alignment with our core values: Teamwork, Client Happiness, Communication, Integrity, and Community.

Preferred

• U.S. personal injury, insurance verification, or medical records experience

• Experience with SmartAdvocate, Case Status, or similar legal case management systems

• Experience supporting remote U.S. legal teams; English-Spanish bilingual skills

CORE COMPETENCIES

• Accuracy. Check the source before updating the file

• Persistence. Outstanding records receive consistent follow-up

• Judgment. Escalate discrepancies and do not make unsupported assumptions

• Organization. Every open request has an owner and next step

• Confidentiality. Protect client and medical information

• Communication. Concise, timely, useful status updates

• Dependability. Meet deadlines and raise blockers early

HOW SUCCESS IS MEASURED

Performance should be reviewed at 30 and 90 days, then regularly against the agreed Claims Verification scorecard.

• Verification accuracy on audited matters and correction rates

• Time to complete assigned verification requests against agreed targets

• Percentage of cases with complete, current verification status

• Follow-up timeliness and aging of unresolved tasks

• Quality of case notes, document indexing, and escalation decisions

• Reliability during scheduled U.S. working hours and team responsiveness

• 10 Days – Personal PTO May be used for vacation, personal matters, illness, or other time away from work.
• 11 Days – Floating Holidays Contractors may use these days to observe local, cultural, religious, or family holidays of their choice. Contractors are not required to follow the United States federal holiday schedule.