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Finally, the RA will support HEOR-related work, including database analyses using administrative claims or electronic medical records databases, literature review and evidence syntheses, and economic modeling / value dossier development.
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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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Support reinsurance claims recovery process, providing on-going reporting to Group, responding to inquiries, and collaborating with other teams to ensure accurate reporting and recoveries are received in a timely manner from reinsurers and state catastrophe funds.
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About NYC Health + Hospitals
$175ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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With 98% of cyber insurance claims in the past five years coming from small and mid-size businesses with revenue under $2B, providing an integrated solution to help manage risk is more critical than ever.
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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. Job DescriptionWe are seeking an AVP - Product and Regulatory Counsel reporting to VP - Associate General Counsel.
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Manage all aspects of dispute resolution, pre-litigation investigations, and litigation, including assessing new employment related charges, complaints, and attorney demand letters; developing strategy to resolve them; engaging and supervising outside counsel as applicable; and providing clear, concise, and accurate guidance.
$236,875 - $300,035 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claims Processing, Provider Appeals & Disputes and Network Performance Standards. Assists in creation of reports, attends, and presents at Plan committee meetings (Grievance, SIC, etc.
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This position supervises: Senior Director-Contracts & Claims; Senior Director-Compliance & Risk Officer; Senior Program Director-Research & Community ServiceEducation, Experience, and Qualifications:Bachelor’s Degree in Public Administration, Business Administration, Auditing, Pre-Law or related field and ten (10) years of progressively responsible experience in compliance matters, dispute resolution, and familiarity with administrative law and procedures required.
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Prepare, revise and proofread various agreements including insurance, ancillary, nursing home, Medicaid, HMO and transactional to support health plan business activities, responses to Administrative Complaints, Closing Orders, settlement agreements, pleadings, correspondence, memoranda, motions, briefs (Federal, State and local level), etc.
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Develop and foster relationships with reinsurance brokers and reinsurance markets to facilitate placements, execution of contract wording, timely claims payments and gain market intelligence. Work with Underwriting, Finance, Actuarial and Claims to gather data to assist in reinsurance submission preparation (data to be provided to a broker who will prepare submissions.
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Act as manager on duty for the hotel in the absence of the Front Office Manager dealing with complaints, problem-solving, disturbances, special requests, and any other issues that may arise. Our client, a luxury hotel in Manhattan, is looking for an experienced Hotel Front Desk Manager to join their team for a few months.
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Maintains the Sales Floor and merchandise presentation in the Freezer/Cooler/Deli area in accordance with Company policies and procedures by properly handling claims and returns; zoning the area; receiving and stocking merchandise; setting up, cleaning, and organizing product displays; removing damaged goods; signing and pricing merchandise appropriately; completing required audits, paperwork, logs, and other required documentation; and securing fragile and high-shrink merchandise.
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Ability to obtain Property Deeds / Corporate Business search about premises liability claims. Knowledge of No-Fault applications, filing of claims/procedures, deadlines. Ability to set up property damage claims.
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Communicates guest problems or complaints to the Spa Manager on Duty. Maintain safety and sanitation standards. Must have at least 1 year of luxury retail sales experience. Benefits: 401(k) matching Dental insurance Employee discounts Health insurance Paid time off Vision insurance Compensation: $20.00 hourly + Gratuity Pool + Retail CommissionCompany OverviewTrilogy Spa Holdings is a professional spa management company dedicated to creating and operating the most innovative, service-centric, and performance-optimized branded spas in the hospitality industry.
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claims complaints jobs Company: Metroplus Health Plan in Newark, NJ
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