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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.
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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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Maintains the Gas Station/Car Wash area in accordance with Company policies and procedures by properly handling claims and returns, zoning the area, arranging and organizing merchandise/supplies, identifying shrink and damages, and ensuring a safe work environment.
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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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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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Maintain licensure through completion of yearly Continuing Legal Education (CLE) requirements of the District of Columbia, to include the Court of Appeals for Veterans Claims and the U.S. Federal Circuit Court.
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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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The Claims team is currently seeking an experienced Auto Adjuster to join in their Worcester MA - Richmond, VA - Itasca, IL or Howell, MI office location. Be responsible for some to all aspects of each claim, including informal hearings, arbitrations and small claims litigation and maintaining a high level of productivity, confidentiality, and customer service.
$50,000 - $60,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Ability to drive scientific excellence, understand key technologies, build models, and communicate effectively within R&D.5+ years in FMCG or Consumer HealthcareExperience in Consumer Science/Products Research (qualitative & quantitative research, consumer modelling, upstream/front end consumer need definition AND downstream/product validation and claims substantiation)Excellent analytical skills, including strategic thinking.
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ESIS , a multi-line Third-Party Administrator (TPA), provides claims, risk control & loss information systems to Fortune 1000 clients across its North American platform. ESIS provides a full range of sophisticated risk management services, including workers compensation claims handling; a broad spectrum of casualty insurance products, such as general liability, automobile liability, products liability, professional liability, and medical malpractice claims handling; and disability management.
$99,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Provide advice and counsel to clients on a broad array of issues relating to the legal risks and requirements associated with branded prospection pharmaceutical products (including the Anti-Kickback Statute, the False Claims Act, the Food, Drug and Cosmetic Act, FDA advertising & promotional regulations, OIG Guidance, the PhRMA Code and the Sunshine Act.
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Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy. The Provider Reimburse Admin ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.
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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. + Knowledge of and/or ability to learn and enforce current NFPA Standards applicable to work operations.
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Salary: Data Entry Work from Home - Part Time Computer Job Based on experience, this position pays up to $34.00 per hour. But none of these work unless we have participants who are willing to answer questions, join focus group zoom meetings or even test products hands-on and provide feedback.
$26 an hourPart-timeWork from homeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Incredible Work/Life benefits include an annual membership to access to backup care services for dependents through retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more.
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claims job Title: to work in Henrico, VA
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