Claims Verification Case Manager (Contractor)

Overview

This role is a case-development professional responsible for maximizing case value, improving the client experience, and delivering attorney-ready files. The Claims Verification Case Manager serves as the bridge between matter intake and legal teams by managing file setup, conducting coverage and liability investigations, handling early client communications, and ensuring assigned personal injury matters are accurate, complete, and ready to move forward without avoidable delay.

This is a remote role working closely with U.S.-based Claims Verification and Legal Support teams. Strong written English, disciplined follow-up, careful handling of confidential records, and consistent overlap with Louisiana business hours are required.

Responsibilities

File Setup and Development

• Review newly 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 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 systems and access controls.
• Follow attorney supervision, confidentiality, and data security requirements.
• Do not independently offer legal advice, negotiate claims, or make legal determinations.

Requirements

• 1+ years in legal support, insurance claims, case management, or a similarly detail-heavy role.
• Strong investigative judgment and effectiveness in identifying missing information.
• Professional, clear, and compassionate written and spoken English; 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 core values: Teamwork, Client Happiness, Communication, Integrity, and Community.

Preferred Qualifications

• 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.

Compensation & Benefits

• 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).

Location

• Remote role with consistent overlap with Louisiana business hours. Reliable internet connection and agreed U.S. business-hour availability are required.

How Success Is Measured

• Performance 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.