TEMP-Senior Medical Pricing Specialist

Company

Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc.

Job Description

Summary:

We are looking for a highly capable Senior Medical Pricing Specialist to help us on a temporary assignment with an estimated end date of DATE and work from anywhere in the United States.
 

The Senior Medical Pricing Specialist is responsible for overseeing and coordinating the accurate processing of medical payments for Workers’ Compensation (WC) claims in accordance with applicable state fee schedules. This role ensures 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 in this role are required to accurately record all hours worked and submit timesheets in accordance with company policy. Overtime may be assigned as business needs dictate, and employees are expected to work overtime when required.
 

Essential Responsibilities

• Working under technical direction and within significant limits and authority, 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
   

Qualifications / Experience Required:

• A practical knowledge of medical terms, procedures, and management along with the litigation process, as well as exceptional customer service focus typically achieved through:.
  • 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 above.. 
• Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers’ ability to be profitable).
• Must have excellent communication skills and the ability to build lasting relationships.
• A strong focus on execution in getting things done right.  Proven ability to consistently produce and deliver expected results to all stakeholders by: 
  • Finding a way to achieve success through adversity. 
  • Being solution (not problem) focused 
  • Thinking with a global mindset first. 
• Successful traits (flexibility, ability to thrive in change, being resourceful on your own) necessary to work in a fast paced environment that is evolving constantly. 
• Excellent evaluation and strategic skills required.
• Must possess a strong customer focus.
• Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.
• Must work independently and demonstrate the ability to exercise sound judgment.
• Demonstrates inner strength.  Has the courage to do the right thing and demonstrates it on a daily basis.
• Exhibit natural and intellectual curiosity in order to consistently explore and consider all options and is not governed by conventional thinking. 
• Proficient in MS Office Suite and other business-related software.
• Polished and professional written and verbal communication skills. 
• The ability to read and write English fluently is required. 
• Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.
   

The base salary range provided below is for hires in those geographic areas only and will be commensurate with candidate experience. Pay ranges for candidates in other locations may differ based on the cost of labor in that location. In addition to base salary, this position is eligible for an annual bonus based on company and individual performance as well as a generous benefits package.

• 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 Pay Ranges: $37.66 per hour - $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, & Washington State Pay Ranges: $41.44 per hour - $48.79 per hour
  
   
• New York City, Los Angeles and San Francisco metro areas Pay Ranges: $45.16 per hour - $53.16 per hour
  
   

About Working in Claims at Argo Group
Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful.
 

Our Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions and treat each case as the unique situation it is.
We have a very flat organizational structure, enabling our employees have more interaction with our senior management team, especially when it relates to reviewing large losses.
 

Our entire claims team works in a collaborative nature to expeditiously resolve claims. We offer a work environment that inspires innovation and is open to employee suggestions. We even offer rewards for creative and innovative ideas.
 

We believe in building an inclusive and diverse team, and we strive to make our office a welcoming space for everyone. We encourage talented people from all backgrounds to apply.
 

PLEASE NOTE: 

Applicants must be legally authorized to work in the United States. At this time, we are not able to sponsor or assume sponsorship of employment visas.

If you have a disability under the Americans with Disabilities Act or similar state or local law and you wish to discuss potential reasonable accommodations related to applying for employment with us, please contact our Benefits Department at 210-321-8400. 

Benefits and Compensation

We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program—including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.

Core Values

At Clearbrook our Core Values are Integrity, Collaboration, Pursuit of Excellence and Forward Thinking. These values reflect who we are today and who we apsire to be - guiding how we work, how we lead and how we succeed.