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Job ResponsibilitiesConfirms coverage of claims by reviewing policies and documents submitted in support of claimsDirects and monitors assignments to experts and outside counsel, ensures effective vendor and litigation management on moderate to high complexity claims including demonstrable savingsAnalyzes coverage and communicates coverage positionsPrepare coverage position letters on matters typically in litigation without assistance of outside coverage counsel.
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Advise on relevant federal and state laws, including but not limited to fraud and abuse laws (i.e. Anti-kickback Statute, Stark, Civil Monetary Penalties Law, False Claims Act), licensing and accreditation, HIPAA/HITECH, EMTALA, digital health, telehealth/telemedicine, medical staff/peer review issues, healthcare compliance matters, billing, reimbursement and claims issues (to include Medicare/Medicaid.
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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.
$208,250 a yearFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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We are seeking qualified candidates for an Associate General Counsel at our Corporate in Glen Allen, VA. Responsibilities include protecting the company's interests and reputation by overseeing a broad variety of legal and regulatory matters with global implications, including all litigation, claims, internal investigations, regulatory compliance, and global risk management and insurance.
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The Medicaid Billing Specialist is responsible for the accurate and timely editing, preparation, submission of electronically and manually processed claims to third party payers in accordance with policies and procedures.
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Assist in reporting and investigating workers compensation and general liability claims on job sites; act as a liaison with workers compensation issues. Construction Site Safety Technician Certification (CSST) or Construction Health & Safety Technician (CHST) is a plus.
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Directs and monitors assignments to experts and outside counsel, ensures effective vendor and litigation management on moderate to high complexity claims including demonstrable savings. Successful completion of 5 years as a Claims Examiner.
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Claims Examiner’s conduct the handling of claims in the utmost of good faith in compliance with the rules, regulations and statutes. This role is responsible for the analysis and management of complex workers’ compensation claims.
$81,593 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Ensure Proof of Claims, Motions for Relief, Payment Change Notices, Post Petition Fees and Costs are prepared by counsel, are accurate and all aspects of the bankruptcy are handled according to investor guidelines and timeframes.
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Actively engages 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, and fire or fraud investigators, and other experts.
$133,700Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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As an experienced bodily injury adjuster you will be fully responsible for the analysis, investigation, evaluation, negotiation, and resolution of claims requiring thorough investigations including telephone contacts with the involved parties; technical expertise and complex analysis.
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Product Liability: Defend against insurance subrogation and first-party litigation/claims, including personal injury, wrongful death, property damage, and alleged noncompliance with state consumer laws.
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Proof of Claims. Works with the Foreclosure, Loss Mitigation, Escrow Analysis, Taxes and the Insurance department communicating the bankruptcy status. Our client is a Fortune 500 Financial Services Company and they are hiring a Bankruptcy Specialist to join their team in Glen Allen.
$20.03 an hourTemporaryExpandUpdated 17 days ago - UpvoteDownvoteShare Job
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As a Field Auto Adjuster, you will play a crucial role in our Auto claims handling process by writing estimates directly at customer homes, repair shops, or tow yards. We’ve been an industry leader in pricing sophistication, telematics, digital photo claims and, more recently, device and identity protection.
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Scrum Master/Business Analyst with experience in Azure DO, Jira, Confluence, and claims experience. Knowledge of underwriting, claims processing, policy administration, and regulatory compliance.
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claims job in Henrico, VA
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