Title: Grievance & Appeals Nurse (RN) Job Responsibilities: The Grievance & Appeals Nurse (RN) is responsible for managing and processing medical necessity appeals requests from members and providers. Key responsibilities include: - Supporting legal, management, and executive leadership by overseeing State Fair Hearing...
Title: Insurance Bad Faith Discovery Analyst Job Responsibilities: The Insurance Bad Faith Discovery Analyst, referred to as Discovery Analyst II, is tasked with managing the records function within the Suits Against the Exchanges (SAE) group. This role involves acquiring and administering documents...
Job Title: Paralegal I Job Responsibilities: - Research... and analyze legal sources including statutes, judicial decisions, and legal articles to effectively respond to subpoenas served upon any entity within the company group of companies. - Collect, review, redact, categorize (e-tag), and...
executive leadership in managing State Fair Hearing and External Medical Review requests. - Act as a resource for clinical and non-clinical teams by conducting thorough investigations and reviews of medical necessity appeals in preparation for litigation. - Document and log appeal... information...
Job Title: Legal Specialist (Paralegal) Job Responsibilities: The Legal Specialist (Paralegal)... at the company is... tasked with providing essential support to the Legal Department and other departments across the organization on various legal and regulatory matters. The position involves working under the...
Job Title: Paralegal Specialist Job Responsibilities: The Paralegal Specialist... at the company is tasked with providing extensive support to the Legal Department and other departments within the company on various legal and regulatory matters. This role involves working under the supervision of...