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In this role you’llOversee the execution of intricate projects within CLX, ensuring alignment with business goals and timely project completionBuild and maintain strong relationships with key stakeholders, including executive leaders and Product partners, to drive strategic initiatives for operational excellenceSupport comprehensive financial analysis and forecasting activities, contributing to the financial strategy of claims experience operations.
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Our forensic accounting experts apply their understanding of industry, accounting, finance, and economics to address complex issues that arise in dispute resolution in areas such as forensic and fraud investigations, commercial damages, bankruptcies, intellectual property, insurance claims, and business valuations.
$75,000 - $100,000Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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In this role, the successful candidate As part of the Pharmacy Business & Analytics (PBA) team, this position monitors and manages Third Party Administrator (TPA) split-billing software reports to ensure regulatory compliance and optimization of 340B Program revenue.
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Handle Union issues: Taft-Hartley Requests, SAG/AFTRA P&H Audits and oversee handling of union claims with talent payroll company. Draft and negotiate various third-party agreements, including music, licensing of footage and images, artwork and recognizable structures, apps, and other third-party rights.
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Filing of documents via NYSCEF in the various e-filing State courts (i.e. appaellate, court of claims, criminal, family, NYC civil, supreme civil, surrogate, and town/village court) and via NextGen CM/ECF is the various e-filing 94 district courts and 12 courts of appeals.
$95,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Extensive hands-on experience working with large datasets using tools like AWS SageMaker, Python, R, and SQL. Strong knowledge of various pharmaceutical data sources, including patient claims data from IQVIA/SHA, sales force activity data, physician prescription data, and real-world evidence data such as MarketScan and Optum claims.
$215,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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As a Team Leader, you will be responsible for product quality, and performance of the liability claims professionals on your team and supporting the VP Claims Manager. You may be responsible for maintaining a minor caseload, as determined to be appropriate by the VP Claims Manager.
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JOB DESCRIPTION :Essential Duties & Responsibilities:Performs a combination of duties in accordance with departmental guidelines:Manages an inventory of the most complex and high exposure Lawyers Professional Liability Claims by following company protocols to manage and oversee all aspects of the claim handling, including coverage determinations, investigations, and resolution strategies which may include pursuit of risk transfer, extensive negotiations and complex litigation management.
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Actively engage in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants nurse consultants, and fire or fraud investigators, and other experts.
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4 years experience with Guidewire Cloud Claims migration. 4 years of experience working in one of the following sub service areas: Insurance Products, Underwriting, Claims, Billing & Payments, Policy Administration or Distribution.
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Small Claims Litigation Contract Attorney. Davis Wright Tremaine LLP has an exciting contract opportunity to help manage and litigate a large docket of cases, primarily in small claims courts throughout the tri-state area.
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Your role will also involve acting as a central conduit, creating a feedback loop between our advisory, placement, and claims teams to ensure that valuable insights are considered within Marsh products and insurer forms.
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If so, we are looking for a Biomedical/Biomechanical Engineering Expert 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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We are seeking a Senior Civil Engineer with broad expertise in land development and/or site/civil/heavy construction project management to perform investigations and analyses, prepare reports, and provide expert testimony where technical knowledge, skill, experience, training and/or education are needed to help resolve civil litigation and insurance claims.
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EQ offers a comprehensive product set, including transfer agency services, cap table management, equity compensation services, proxy solicitation and advisory services, private company solutions and bankruptcy claims administration services.
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claims tpa jobs Company: Metroplus Health Plan in Newark, NJ
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