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Providing financial analysis and expert testimony in a range of dispute situations: securities litigation, marital dissolution, antitrust claims, consumer fraud, labor and employment and other class actions, intellectual property, professional malpractice, lost profits, valuations, breach of contract, purchase price disagreements, business interruption, environmental claims, construction claims and fraud cases.
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In this role, the AVP, Claims will be responsible for leading and managing all aspects of Claims responsibilities and working with the Claims Managers to manage and ensure the Workers' Compensation claims activities are being handled within the AmTrust Best Practices.
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Adjudicate all claims types including Dental, Vision and Medical claims for inpatient and outpatient facilities, physician claims, In and Out of Network claims, Medicaid reclamation (HIPD), outpatient lab and radiology, accident and Third-Party Liability (TPL) claims, by calculating benefit due to approve or deny, based on SPD and within accepted corporate cycle timeframe.
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Department(s): Grievance & Appeals Resolution Services (GARS)Reports to: Manager, Grievance & AppealsSalary: $24.52 - $31.04 Duration: up to 6 months Job Summary The Grievance Resolution Specialist coordinates the Grievance and Appeal resolution process, responds to verbal and written Grievances and Appeals from members and/or providers relating to member eligibility and benefits, contract administration, claims processing, utilization management decisions, and pharmacy and vision decisions.
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Set the strategic vision and direction for the Global Legal Services Group and ensure execution in mission critical subject matter, including: Corporate Governance, Strategic Transactions and Financings, Regulatory Compliance, Contracting Process, Litigation and Claims, Risk Management, Safety and Loss Control, Labor Relations, Employment Practices and External Counsel relationships.
$300,000 - $500,000Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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As a Manning Kass Workers' Compensation attorney, you'll make a difference for business owners and employers by defending them against questionable or denied workers' compensation claims and providing exceptional legal representation in their time of need.
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Provide opinions to Managing Attorney, Assistant Managing Attorney, staff, clients and claims customers. Provide effective and timely communications, information, legal advice and other services to clients and claims customers on legal and factual issues in a technology driven environment.
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If so, we are looking for a Part-time Materials Engineer/Materials Scientist with broad design and manufacturing expertise to join our national Materials Science practice group to provide investigation, analysis, reports, and testimony where technical and scientific answers are needed to help resolve civil and criminal litigation and insurance claims.
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Our core expertise is in Project Controls which includes Scheduling, Cost Controls, Document Management and Controls, Budget tracking and monitoring, Estimating, Risk Analysis, Claims avoidance and Mitigation, Change Management and Earned Value Management.
$65,000 - $72,000 a yearFull-timeRemoteExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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ABC Medical is one of the nation’s leading urological supply providers, and serves as a one-stop shop with a comprehensive line of medical supplies and service that includes: Urological, Incontinence, Wound Care, and Ostomy.
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Knowledge of HMO, POS, PPO, EPO, IPA, Medicare Advantage, Covered California (Exchange), capitation, commercial and government payors (i.e. Medicare, Medi-Cal, TriCare, etc) and how these payors process claims.
$20.82 - $32.03 an hour depends on education, experienceFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Obtains the maximum amount of reimbursement by evaluating claims at the contract rate with the use of the contract management tool for proper pricing (Examples: APC, DRG, APRDRG). Obtains the maximum amount of reimbursement by evaluating claims at the contract rate with the use of the contract management tool for proper pricing (Examples: APC, DRG, APRDRG.
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To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
$45.71 - $47.86 an hourExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Providence is calling a Claims Specialist who will work remotely within our footprint states in, AK, CA, MT, OR, TX, or MT. This position reports to the Research Claims Manager and includes collaboration with several research entities within Providence.
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Minimum of 50 claims per day doing insurance AR follow-up. Working knowledge of Epic Resolute, Eric Care, and Epic CPOE. legal support, auto ,home insurance, pet insurance, and employee discounts with preferred vendors.
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claims job in Orange, CA
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