Job Title: Legal Counsel, **Members Only** Contracting Job Responsibilities: The Legal Counsel for **Members Only** Contracting at the company is responsible for providing comprehensive legal advice and recommendations to support initiatives and projects aligned with the clients' overarching objectives and needs. This role primarily focuses on large-scale, high-financial-level projects with significant departmental or organizational impact and moderate risk. The Legal Counsel is expected to
Job Title: Investigator Sr Job Responsibilities: The Investigator Sr is charged with the independent identification, investigation, and development of complex cases against individuals or entities involved in healthcare fraud, with the goal of recovering corporate and client funds that have been paid out on fraudulent claims. The primary duties include, but are not limited to, the following: - Conducting reviews of claims to ensure appropriate coding, engaging in data minin
Senior Counsel Job Responsibilities As a Senior Counsel at the company, you will be entrusted with high-quality, proactive case handling and will have the opportunity to leverage your legal expertise and litigation skills to independently handle a caseload of higher exposure cases and more complex litigation matters. Your responsibilities will include: - Utilizing trial experience to effectively apply litigation skills and techniques to try cases to verdict or negotiate re
Job Title: Investigator Sr Job Responsibilities: The Investigator Sr is tasked with independently identifying, investigating, and developing complex cases against perpetrators of healthcare fraud to recover corporate and client funds paid on fraudulent claims. Key responsibilities include: - Reviewing claims for appropriate coding, data mining, entity review, law enforcement referral, and utilizing proprietary data and claim systems to review facility, professional, and phar
Job Title Cyber Claim Counsel Job Responsibilities - Follow operational policies to analyze, investigate, and resolve Bond & Specialty Insurance (BSI) claims of varying levels of severity with moderate supervision from claims management. - Prepare and present reports for management that accurately reflect loss development, potential/actual financial exposure, reserve adjustments, coverage issues, and claim and recovery strategies. - Retain, monitor, and manage outside c