Complex Claims Specialist - MPL ... Bring your Passion and Enthusiasm to our Team! We are a fun, innovative and growing Claims team where you’ll get... the opportunity to learn multiple insurance products and interact with business leade...
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The candidate will provide legal services on a variety of issues related to Medicaid, the Children’s Health Insurance Program and the behavioral health system. Major duties and responsibilities include to: Perform legal research, provide legal advice, and prepare related legal...
General Counsel - Health Care The candidate will perform legal research, provide legal advice, and prepare related legal documents (contracts, intergovernmental agreements, operational protocols, and agency policies) consistent with state and federal law regarding all aspects of the administration of...
Senior Claims Examiner – Allied Health... resolves moderate to complex claims that include all phases... of litigation. Accurately documents claim files with all relevant claim documentation, correspondence, and notes in compliance with company policies and applicable regulatory authorities. With minimal...
Complex Claims Specialist, Bodily Injury The... resolves complex to severe claims that include all phases... of litigation. With minimal supervision, drafts complex coverage letters, including reservation of rights and denial letters. Reviews and analyses claim documentation and legal filings. Drives...
Claims Examiner Duties: Adjusts and... resolves moderately complex claims that may include some... litigation. Accurately documents claim files with all relevant claim documentation, correspondence and notes in compliance with company policies and applicable regulatory authorities. Drafts coverage letters, including reservation...
developed will be handled by the specialist from conceptualization to finished product. Specific asks may be requested by customers of PNI, requiring the specialist to manage multiple ongoing projects at the same time. Conducts detailed reviews on claims that h...
to identify and seize assets in connection with criminal and civil matters, and will use litigation tools (., fraudulent transfer actions, discovery, attachment,... garnishment) to expand recovery for victims and collects debts owed to the government. Depending on the needs...
connection with criminal and civil matters, and will use litigation tools (., fraudulent transfer actions, discovery, attachment,... garnishment) to expand recovery for victims and collects debts owed to the government. Depending on the needs of the office, handle defensive ma...
investigations of allegations of fraudulent and abusive practices. Work... assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Conduct comprehensive investigations of reported, alleged or suspected fraud related to laboratory services. Thorough case...
investigations of allegations of fraudulent and abusive practices that... play a key role in determining provider recommendations. Coordinates investigation with law enforcement authorities and assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site and virtual audits of...