Title: Nurse Appeals – Litigation & Legal Support Job Responsibilities: The Nurse Appeals – Litigation & Legal Support role involves a variety of critical responsibilities aimed at supporting legal and clinical operations within the organization. The primary duties include: - Investigating and processing...
Title: Senior Legal Counsel I Job Responsibilities: The Senior Legal Counsel I is responsible for providing legal advice and counsel to corporate officers, managers, and employees of the Company and its subsidiaries, affiliates, and joint ventures. This role primarily serves...
The following jobs are no longer active but were real openings previously posted by employers. These listings provide valuable insight into employer hiring trends and frequently lead to job offers. In many cases, employers are still hiring or open to strong candidates even if no new job is posted. Applying to these listings often makes you the only applicant, increasing your chances of being hired.
Nurse Consultant - Nurse Reviewer The candidate will provide consultative services. Will work with liability claims and staff legal files. Evaluate medical treatment to ensure quality, effective and cost-effective care. Supply Technical resource to claims. Review medical records to analyze treatments verses standards of care/ medical necessity. Confirm acceptable standards of medical care by utilizing clinical expertise, professional judgment, supported by established... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Specialist The candidate will handle maintenance and administration of all Contracts company provides service for including Managed Care, Government, Hospice, Skilled Nursing, Non-Participating or Out of Network, Professional Service Agreements and Patient Pay Contracts. Administration of contracts includes but not limited to a complete redline/review of payer contract language, policies and procedures, provider manuals, billing rules and guidelines. Participates an... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Professional Case Review Nurse The candidate will be responsible for: working with liability claims and staff legal files; evaluating medical treatment to ensure quality, effective and cost-effective care; supplying technical resource to claims; reviewing medical records to analyze treatments verses standards of care/ medical necessity; confirming acceptable standards of medical care by utilizing clinical expertise, professional judgment, supported by established cri... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Specialist II - Contracts Administration Duties: Will have primarily responsibility is the maintenance and administration of both Contracted and Non-Contracted Payers that company's provides service. Will be responsible for the Quality Review (QA) of all Contracts loads and updates. Conducts and leads monthly team meetings to review top account issues, denials, adjustments and held item errors and recommends quarterly review topics to the managed care team. Communic... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Healthcare Industry Duties: Responsible for the Quality Review (QA) of all Contracts loads and updates. Conducts and leads monthly team meetings to review top account issues, denials, adjustments and held item errors and recommends quarterly review topics to the managed care team. Communicates with the Billing Center, Central Intake, Sleep Central and Locations regarding contract changes and/or updates including distribution of reference guides as required. Conducts/l... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Nurse Consultant (Virtual) Duties: Working with Liability claims and Staff Legal files. Evaluating medical treatment to ensure quality, effective and cost-effective care. Supply Technical Knowledge resource to claims. Review medical records to analyze treatments verses standards of care/ medical necessity. Confirm acceptable standards of medical care by utilizing clinical expertise, professional judgment, supported by established criteria documented in accepted peer... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
File Review Nurse The candidate will use clinical expertise, nursing judgment and established medical criteria to formulate opinions as to the relatedness of medical conditions. Will review and analyze medical records that are provided by a claims professional and/or attorney to compare the documented injury/diagnosis established and treatment rendered. Collaborate on liability claims and claims cases that have litigation activity. Provide subject matter expertise an... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Specialist I The candidate’s primarily responsibility is the maintenance and administration of both Contracted and Non-Contracted Payers that the company provides service. Responsible for the Quality Review (QA) of all Contracts loads and updates. Conduct and lead monthly team meetings to review top account issues, denials, adjustments and held item errors and recommends quarterly review topics to the managed care team. Communicate with the Billing Center, Central... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Specialist II The candidate’s primarily responsibility is the maintenance and administration of both Contracted and Non-Contracted Payers that the company provides service. Responsible for the Quality Review (QA) of all Contracts loads and updates. Conduct and lead monthly team meetings to review top account issues, denials, adjustments and held item errors and recommends quarterly review topics to the managed care team. Communicate with the Billing Center, Centra... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here
Specialist The candidate’s analysis will include a quality review of contract plan type and class for accurate revenue tracking, payer rules to include prior authorizations, cap rental rules and appropriate document requirements which all contribute to held item and adjustments. Assists in creating and maintaining Firm’s Supplier Diversity Database including yearly mailing to all Firm vendors. Communicates with the Billing Center, Central Intake, Sleep Central and l... read more
Note: This job is no longer active. It was originally posted on [Date] and is part of LawCrossing’s historical archive of legal jobs. While the position may have been filled, employers often remain open to exceptional candidates for similar roles. LawCrossing has tracked this employer's hiring activity for over 25 years. This listing is provided for informational and outreach purposes and may still lead to employment. Learn more about archive jobs and how powerful they are for your search, click here