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As a PSU adjuster, you will have direct oversight of complex and severe general liability, product liability, employers' liability, and auto liability claims where AIG has primary and/or excess layers of coverage.
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In this role you will collaborate with our team of pricing, claims, distribution, product management, underwriting and claims experts to sell and deliver consulting and technology solutions to our personal lines insurance clients.
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WTW is looking for a leader with personal lines insurance analytics experience in the North American market to join as a Property & Casualty (P&C) Director in our Insurance Consulting and Technology (ICT) practice.
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Strong knowledge of key laws and regulations impacting the pharmaceutical industry including the PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state transparency and disclosure laws.
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Such disagreements and/or claims may be resolved through an impartial hearing, a formal method in which the parties present and refute evidence before a hearing officer. OATH also houses the Center for Creative Conflict Resolution which provides mediation and restorative justice support to City government agencies and the general public, and the Administrative Judicial Institute, a resource center that provides training, continuing education, research and support services for administrative law judges and hearing officers.
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Compiles and organizes medical records; distributes to Medicare Compliance nurses for analysis; and provides guidance and advice on processing claims based on nurses' analysis. Analyzes lien notices for accuracy, communicates with the CMS to efficiently facilitate lien resolutions on claims and/or prepare MSA submissions in accordance with submission guidelines from CMS as assigned.
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Collaborate with various functional areas across the organization, including underwriting, claims, risk control, actuarial, legal, marketing, and regulatory compliance in creating products. We are seeking an AVP - Product and Regulatory Counsel reporting to VP - Associate General Counsel.
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Understanding of Healthcare & Insurance claims analytics (SAS, R, Python) This role will be hands-on with building and implementing predictive models for healthcare organizations with strong technical skills using SAS, SQL, R, Python, Power BI, etc.
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Experience working with healthcare data, including but not limited to eligibility, claims, payments, and risk adjustment datasets. Amazon Redshift, Google BigQuery, and Snowflake. Apache Beam and Apache Spark.
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Reinsurance Claims Analyst. Our client is seeking an accomplished claims professional to technically manage an assigned workload of global Property and Casualty multi-line reinsurance claims, ensuring all claims are handled in accordance with regulatory guidelines, while applying Company and Best Practices.
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Analyze population health and performance improvement metrics, analyze payer claims data to monitor quality performance such as HEDIS metrics. In addition, responsibilities include analyzing population health and performance improvement metrics, synthesizing and analyzing payer claims data feeds to monitor quality performance such as HEDIS metrics.
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Provide legal advice and counseling to clients on diverse family law issues, including prenuptial and postnuptial agreements, equitable distribution, property disposition, and child and spousal support.
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The Sales Field Supervisor spends most of their day meeting and closing insurance company Adjusters to pay homeowners what they are entitled to on wind and hail claims for Roofing, Siding, and gutter projects.
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If so, we are looking for a Full or 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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Associate Director of Nursing (ADN), Clinical and Community-Based Services will oversee a team of Transitional Care Nurses (TCNs) responsible for the coordination, management and disposition of patient referrals to the Certified Home Health Agency (CHHA.
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claims complaints disposition jobs Company: Metroplus Health Plan in Newark, NJ
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