Personal Injury Claims Specialist

Personal Injury Claims Specialist - Case Work Up and Medical Management

Join GGRM Law Firm, Nevada's premier injury law firm in Henderson, NV, as a Personal Injury Claims Specialist, focusing on Case Work Up and Medical Management, and make a significant impact on the lives of those who have been injured. If you enjoy interacting with clients and are committed to providing excellent and compassionate representation, we invite you to join our team.

For over 50 years, GGRM Law Firm has been a cornerstone of the Las Vegas community, dedicated to serving injured Nevadans by achieving maximum recovery and restoration. Being an employee at GGRM means being part of a supportive and team-oriented workplace where your contributions are valued and your professional growth is encouraged. We provide a flexible schedule that allows employees to choose their arrival time within a two-hour window, supporting a balance of personal and professional commitments. Join us and help continue our proud tradition of excellent service to our community.

Salary Range

• $48,000 - $95,000 - Depending on experience

Position Summary

The Claims Specialist - Case Work Up and Medical Management serves as a crucial member of GGRM Law Firm, focusing on comprehensive case development and medical evidence management. Working closely with Personal Injury Attorneys, this position builds strong case foundations through meticulous medical record organization, treatment monitoring, and evidence development while embodying GGRM's values.

Essential Duties and Responsibilities

The essential functions include, but are not limited to, the following:

• Processing assigned claims in accordance with Firm policies and procedures 
• Ensuring case management software (CMS) feed is cleared daily 
• Completing all assigned tasks by relevant deadlines 
• Documenting all relevant activity in CMS properly 
• Ensuring emails are cleared daily 
• Completing monthly Meaningful Client Communication (MCC).
• Leading the collection and analysis of medical evidence, including requesting and reviewing medical records, bills, and treatment chronologies.
• Monitoring client treatment progress, identifying red-flag medical issues, following up on compliance, and flagging concerns for attorney review.
• Coordinating with healthcare providers and medical experts to schedule appointments, clarify treatment recommendations, and support the development of lifecare plans when necessary.
• Guiding clients through the treatment process by answering medical-related questions, obtaining symptom updates, and documenting life effects and non-economic impacts.
• Managing medical payment claims, establishing and tracking medical liens, and supporting client medical authorization processes.
• Processing assigned claims in accordance with firm policies and supporting investigation efforts in coordination with Investigation Specialists and Claims Specialists – Negotiations & Disbursement.
• Preparing case summaries, attending case strategy meetings, meeting regularly with assigned attorneys, and contributing to ongoing process improvements.
• Mentoring Claims Assistants as needed.
• Performing other duties as assigned. 
• Request and analyze medical records and bills
• Track client treatment progress and gaps
• Identify red-flag medical issues
• Coordinate with healthcare providers
• Organize medical chronologies
• Flag treatment issues for attorney review
• Monitor and document treatment recommendations
• Evaluate need for lifecare planning
• Coordinate with medical experts

• High school diploma or equivalent
• Six months plaintiff personal injury experience
• Understanding of medical terminology
• Knowledge of health insurance practices
• Proficiency in case management software
• Medical record organization expertise
• Documentation and timeline creation
• Microsoft Office suite proficiency
• Skilled communicator
• Authorized Nevada Notary

Preferred Qualifications

• Associates Degree or Certificate in Legal Studies
• Medical background or training
• Bilingual in English and Spanish

GGRM Law Firm provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.