<p><strong>Firm seeks Coverage Opinion Writing Attorney (No Litigation)</strong></p><p><br></p><p>This Attorney opening involves working closely with insurers to provide expert advice and analysis on insurance coverage matters. The ideal attorney will have a deep understanding of various insurance policies and be adept at drafting comprehensive coverage opinions.</p><p><br></p><p>Key Responsibilities:</p><ul><li>Collaborate with insurers to provide advice on insurance coverage and interpret policies.</li><li>Analyze various types of insurance policies across an array of industries.</li><li>Draft detailed coverage opinions based on policy analysis and contract interpretation.</li><li>Maintain effective communication with clients and internal team members.</li></ul><p><br></p><p>Billable hour target: 1850/year</p><p><br></p><p>Can work 100% remote in US (PST work hours)</p><p><br></p><p><u>Perks of Firm</u>:</p><ol><li>Established for over 30 years</li><li>Multiple offices with large firm resources</li><li>Women-owned firm</li></ol><p><br></p>
<ul><li><strong>Position: Claims Examiner - Lost Time (Contract Role)</strong></li><li><strong>Location: 555 Long Wharf Drive New Haven CT USA 06511-5941</strong></li><li><strong>Type: 100% Onsite</strong></li><li><strong>Hourly Pay Range: $30-33/per hour</strong></li><li><strong>Interview Process: Virtual interview 1-2 round of 30 minute interview</strong></li></ul><p> </p><p><strong>Job Description: </strong></p><p>Job Schedule-100% ONSITE</p><p>Job hours-8:30am-5:00pm EST</p><p> </p><p>3 years of Workers Compensation Lost Time Claim Examiner or Commensurate Experience </p><p> </p><p>Duties and Responsibilities:</p><p>- Handles all aspects of workers compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process.</p><p>- Reviews claim and policy information to provide background for investigation.</p><p>- Conducts 3-part ongoing investigations obtaining facts and taking statements as necessary with insured claimant and medical providers.</p><p>- Evaluates the facts gathered through the investigation to determine compensability of the claim.</p><p>- Informs insureds claimants and attorneys of claim denials when applicable.</p><p>- Prepares reports on investigation settlements denials of claims and evaluations of involved parties etc.</p><p>- Timely administration of statutory medical and indemnity benefits throughout the life of the claim.</p><p>- Sets reserves within authority limits for medical indemnity and expenses and recommends reserve changes to Team</p><p>Leader throughout the life of the claim.</p><p>- Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them.</p><p>- Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered.</p><p>- Works with attorneys to manage hearings and litigation</p><p>- Controls and directs vendors nurse case managers telephonic cases managers and rehabilitation managers on medical management and return to work initiatives.</p><p>- Complies with customer service requests including Special Claims Handling procedures file status notes and claim reviews.</p><p>- Files workers compensation forms and electronic data with states to ensure compliance with statutory regulations.</p><p>- Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized.</p><p>- Works with in-house Technical Assistants Special Investigators Nurse</p><p>Consultants Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service.</p>
<p>Are you an experienced <strong>Patient Financial Authorization Specialist</strong> looking to make a direct impact in a clinical setting? We are currently seeking a <strong>Patient Financial Authorization Specialist </strong>to join our in-person team. This is not a remote opportunity—the Patient Financial Authorization Specialist will work Monday through Friday, 8:00 AM to 5:00 PM CST, in a fast-paced, collaborative healthcare environment.</p><p><br></p><p><strong>Responsibilities</strong></p><ul><li>Obtain and manage patient authorizations in a timely and efficient manner</li><li>Provide accurate cost estimates to patients prior to the start of treatment</li><li>Scrub the Daily Appointment Report (DAR) to ensure all scheduled patients have valid authorizations on file</li><li>Support patients in navigating claims reimbursements, particularly those covered by grants</li><li>Collaborate with a remote team and receive hands-on training from a Senior PAA</li><li>Ensure compliance with business casual dress code and participate in on-site interviews</li></ul>
We are looking for a skilled Medical Claims Examiner II to join our team in Roseburg, Oregon. This Contract-to-permanent position involves analyzing and processing healthcare claims to ensure compliance with organizational policies and industry regulations. The role requires excellent attention to detail and the ability to collaborate effectively with healthcare providers, insurance representatives, and other stakeholders.<br><br>Responsibilities:<br>• Review and assess complex medical claims to verify coverage, eligibility, and payment accuracy in accordance with contractual agreements.<br>• Analyze medical records, billing statements, and supporting information to validate claims and ensure compliance with established standards.<br>• Investigate discrepancies in claims, resolve billing issues, and identify fraudulent activities.<br>• Communicate clearly and professionally with healthcare providers, patients, and insurance representatives to address claims-related inquiries.<br>• Collaborate with internal teams, such as billing, collections, and compliance, to resolve escalated claims and investigate claim histories.<br>• Maintain comprehensive electronic records of claims and related documentation for auditing and quality assurance purposes.<br>• Stay informed on healthcare billing practices, insurance policies, and regulatory updates to ensure adherence to current standards.<br>• Propose enhancements to existing processes to improve the efficiency and accuracy of claims handling.
We are looking for an experienced Collections Specialist to join our team in San Francisco, California. In this long-term contract role, you will play a key part in managing billing and collections processes, ensuring compliance, and maintaining accurate financial records. This position offers an opportunity to collaborate with insurance adjusters and utilize tools like QuickBooks Online and HubSpot.<br><br>Responsibilities:<br>• Oversee billing and collections processes, ensuring timely payments from clients.<br>• Utilize QuickBooks Online to manage financial transactions and maintain accurate records.<br>• Collaborate with insurance adjusters to ensure compliance with industry standards.<br>• Communicate with clients and stakeholders to resolve payment discrepancies.<br>• Prepare and manage pricing forms using tools like Xactimate.<br>• Leverage HubSpot for tracking and managing client interactions.<br>• Handle labor and equipment billing with precision and attention to detail.<br>• Conduct outreach to clients regarding overdue payments and account statuses.<br>• Provide regular updates and reports on collection activities and outcomes.<br>• Work onsite with flexibility for remote work once training is complete.
<p>We are looking for a detail oriented Entry-level Claims Representative to join our clients' team in Ontario, California. In this role, you will provide critical support in managing claims-related tasks, ensuring accuracy and efficiency in processing, reconciling, and auditing claims. This is a long-term contract position ideal for professionals with strong organizational skills and a background in medical office operations.</p><p><br></p><p>Responsibilities:</p><p>• Match checks with remittance advice, prepare and insert them into envelopes for mailing.</p><p>• Reconcile processed batches within the audit database to ensure accuracy.</p><p>• Create and mail denial trailers and letters to providers.</p><p>• Print and send out claim requirement letters for Covered California members.</p><p>• Forward claims to the appropriate health plan when necessary.</p><p>• Process and mail claims deemed unable to process, including generating the necessary correspondence.</p><p>• Batch trailers created by various departments and ensure proper documentation.</p><p>• Audit the batch log key to confirm claims have been assigned and logged correctly.</p><p>• Verify member information to determine line of business and coordination of benefits in the system.</p><p>• Collaborate on process adjustments and work independently or as part of a team.</p>
We are looking for a detail-oriented Medical Claims Analyst to join our team in Raleigh, North Carolina. This long-term contract position is ideal for someone with extensive experience in medical claims processing and a strong ability to manage repetitive clerical tasks effectively. The role requires a collaborative team player who is dependable, punctual, and committed to delivering high-quality results.<br><br>Responsibilities:<br>• Process and reconcile medical claims efficiently, ensuring all records are accurate and up-to-date.<br>• Resubmit denied or rejected claims, following proper protocols to secure approvals.<br>• Post payments accurately into multiple systems, maintaining consistency and precision.<br>• Utilize payer portals to manage claims and track progress effectively.<br>• Perform clerical tasks such as data entry and filing with a focus on accuracy and attention to detail.<br>• Collaborate with a team of professionals to ensure smooth workflows and timely completion of tasks.<br>• Monitor claim statuses to identify and resolve discrepancies proactively.<br>• Maintain compliance with relevant policies and regulations in the healthcare industry.<br>• Provide support in behavioral health payment posting processes.<br>• Communicate effectively with team members and external parties regarding claim-related issues.
We are looking for a dedicated Medical Claims Analyst to join our healthcare team in Minneapolis, Minnesota. In this long-term contract position, you will play a vital role in processing leave of absence claims, ensuring compliance with medical certifications, and calculating benefit allocations. This is an excellent opportunity to contribute to a fast-paced industry while leveraging your expertise in medical claims and benefits administration.<br><br>Responsibilities:<br>• Process and manage leave of absence claims by coordinating medical certifications and ensuring timely submissions.<br>• Calculate benefit amounts, including allocations from corporate and state sources, to ensure accurate disbursements.<br>• Review, approve, or deny claims based on established guidelines and medical documentation.<br>• Utilize systems such as ServiceNow and Workday to track, manage, and process claims efficiently.<br>• Maintain detailed records of claims and benefits to ensure compliance and accuracy.<br>• Communicate with healthcare providers to confirm certifications and resolve discrepancies.<br>• Address rejected claims by investigating issues and providing resolutions.<br>• Collaborate with team members to streamline leave administration processes.<br>• Provide guidance to employees regarding medical leave policies and benefits.<br>• Stay updated on state and federal regulations related to leave and benefits administration.
We are looking for a dedicated and detail-oriented Case Manager to join a dynamic plaintiff litigation law firm in Santa Barbara, California. This permanent position offers the opportunity to grow into a leadership role, blending case management expertise with office oversight responsibilities. If you are motivated, organized, and eager to become a key part of a thriving legal team, this role is designed for you.<br><br>Responsibilities:<br>• Assist with legal administrative tasks and learn case processes from intake to settlement.<br>• Support case managers by gaining hands-on experience with file management and workflow.<br>• Take on a manageable caseload as a Senior Case Manager, providing strategic guidance and ensuring timely case progression.<br>• Oversee staff workflows and productivity, stepping into an Office Manager role over time.<br>• Conduct twice-daily team check-ins to monitor task completion and file movement.<br>• Lead hiring, onboarding, and training initiatives for new case managers.<br>• Manage HR-related duties, including tracking time-off requests, conducting employee reviews, and maintaining payroll records.<br>• Organize and improve internal systems to enhance team efficiency and accountability.<br>• Serve as the point of contact for case strategy discussions and file reviews.
