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Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system.
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Your team, consisting of a secretary, paralegal, support specialist, will assist you in preparing necessary legal documentation, conducting depositions, investigating/researching, and evaluating cases for settlement, arbitration, and trial.
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Advocate for clients in a variety of legal forums, including court, mediation, arbitration, and negotiation. Juris Doctor (J.D.) from an accredited US law school. Advocate for clients in a variety of legal forums, including court, mediation, arbitration, and negotiation.
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Represent clients in court, arbitration, and mediation proceedings. As an Associate Attorney, you will be responsible for pre-litigation, litigation, trial preparation, and trial. Featured in CNN, Forbes, The Wall Street Journal, Daily Journal, The Advocate.
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Your team, consisting of a support attorney, secretary, paralegal, support specialist, will assist you in preparing necessary legal documentation, conducting depositions, investigating/researching, and evaluating cases for settlement, arbitration, and trial.
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The Program Manager is a key member of the Medicare Advantage Claims, Configuration and Appeals and Grievance Operations team. Assists in planning, developing, implementing, and managing the Medicare Advantage Claims, Appeals and Grievance program requirements, operational initiatives and policies.
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Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. May also engage in grievance and appeals reviews.
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