Lead Legal Nurse: Medical Cost & Claims Leader
Santa Barbara Cottage Hospital
Santa Barbara Cottage Hospital is seeking a Lead Legal Nurse to play a pivotal role in evaluating medical necessity and appropriateness in claims. The candidate will review demand packages, analyze medical records, and support negotiations in various claims environments. Responsibilities include maintaining relationships with clients and stakeholders, writing reports, and using clinical insights to guide decisions. The role requires strong communication and analytical skills, with a minimum of 5 years in clinical or legal settings. Competitive salary and career growth opportunities await the right candidate. #J-18808-Ljbffr Santa Barbara Cottage Hospital
$200k - $250k
...seeking an IT Product Leader to be accountable... ...owner and delivery lead for the Assumed... ...across Underwriting, Claims, Operations, Finance... ..., forecasting, and cost transparency for... ...environments with multiple legal entities. Core... ...employees: ~ Medical ~ Dental ~...MedicalLegalClaimsTemporary workWork visaFlexible hours$230k - $280k
Job Title: Focus Group Leader - US Miscellaneous Medical & Life Sciences Division: Specialty Risks Reports... ...relevant company, regulatory and legal requirements. Deliver team... ...retain existing. Monitor premiums, costs and claims ratios per contract and take corrective...MedicalLegalClaimsFull timeContract workTemporary workImmediate startHome officeFlexible hours$105k - $155k
...Consultants has been an industry leader in engineering... ...for an experienced Cost Manager (CM) to join our... ...solutions - including claims analysis, due diligence... ...Development allowance; ~ Medical (100% paid by company),... ...; Pet Insurance; Legal Plan; ~ Generous Paid...MedicalLegalClaimsContract workTemporary workFor contractorsFor subcontractorWork at officeFlexible hours- ...VP, Private Company and EPL Claims Leader Location: USA -New York... ...team. This includes leading and developing a team of claims... ...collaboratively with their claim, legal and underwriting colleagues to... ...pregnancy, childbirth, or related medical conditions; protected veteran...MedicalLegalClaimsFull timePart timeWork at officeWork from home
$188k - $282k
...products and portfolios. The role leads the development, review, and... ...key partner to Underwriting, Claims, and Finance, translating... ...confidential counselling, financial and legal advice. Tuition Reimbursement... ..., childbirth, or related medical conditions; protected veteran...MedicalLegalClaimsFull timePart timeWork experience placementWork at officeWork from home2 days per week3 days per week- ...exciting to be out front leading it. At QTS, our... ...infrastructure leader, committed to connecting... ...Who You Are: The Cost Control Manager is... ...including substantiating claim positions.... ...ensure review by the legal department as necessary... ...that includes medical, dental, vision, life...MedicalLegalClaimsContract workFor contractorsFor subcontractorImmediate startWorldwideFlexible hours
- ...Supplemental Products Team Lead (Health Insurance) Join... ...while focusing on cost containment. Our services... ...products insurance claims to ensure that claims are... ...specific to supplemental medical plans and benefits.... ...claims are processed in a legal and ethical manner. Other...MedicalLegalClaimsFull timeWork at officeRemote workWork from homeHome office
- ...and decision-making. Lead and develop an offshore... ...allocated reinsurance costs and capital costs to produce... ...product committee, and claims to improve data quality... ..., financial and legal advice ~ Tuition... ...childbirth, or related medical conditions; protected veteran...MedicalLegalClaimsFull timePart timeWork experience placementWork at officeLocal areaWork from home
$92.7k - $139.1k
...complex, in‑depth analysis of claim payments and its methodology,... ...trends and patterns, to ascertain cost avoidance/overpayment recovery... ...as applicable. Ensure medical claims, records, and other documentation... ..., Medical/Payment Policy and Legal. Build strong stakeholder...MedicalLegalClaimsContract workWork at officeRemote workWork from homeFlexible hoursShift work2 days per week1 day per week$100k - $125k
A leader in claims management is seeking a Sr. Claims Specialist for remote work. This role involves... ...settlements, and coordinating legal defenses. Candidates should have a Bachelor... ...comprehensive benefits package including medical, dental, and 401k. Join a company...MedicalLegalClaimsRemote job- ...interpretation on medium to large complex claims. Substantial direct client contact... ...subrogation contacts. Partners with client legal counsel on coverage, claims and strategy... ...ancestry, physical or mental disability, medical condition, marital status, age, genetic information...MedicalLegalClaimsWork experience placementWork at officeLocal areaImmediate start
$188k - $282k
...reinsurance portfolios. The role leads the development, review, and... ...to QBE Re's Underwriting, Claims, and Finance, and Reserving teams... ...confidential counselling, financial and legal advice ~ Tuition... ..., childbirth, or related medical conditions; protected veteran...MedicalLegalClaimsFull timePart timeWork experience placementWork at officeWork from home2 days per week3 days per week- ...re looking for a Growth Lead, Partnerships &... ...administrators and community leaders Plan and manage educational... ...making clinical claims Podcast & Media Pipeline... ...Nothing publishes without medical sign-off Manage... ...guidelines Coordinate legal and compliance across all...MedicalLegalClaimsFixed term contract
$160k - $190k
...seeking a Senior General Liability Claims Examiner - Bodily Injury to... ...service and driving timely, cost-effective outcomes. This is a... ...closely with leadership, legal partners, and internal stakeholders... ...benefits package including medical, dental, vision, 401(k), and PTO...MedicalLegalClaims$200k - $300k
...& Insurance, you will lead Via's insurance program... ...systems and team to manage claims and litigation... ...insurance: partner with Legal, Finance, and other internal... ...frequency and severity, cost per mile, and retention... ..., including free medical plans and 401K matching...MedicalLegalClaims$31.18 - $38.97 per hour
Lead Treasury Management Small Business Support (Hybrid) How would... ...Capture, Bill Pay, and fraud claims Assist customers and internal... ...and Wellness benefits including Medical, Dental and Vision Plans,... ...Illness, Hospital Indemnity and Legal plans. We are an equal opportunity...MedicalLegalClaimsHourly payWork at officeLocal areaRemote workFlexible hours2 days per week3 days per week- ...high-exposure personal injury claims during all phases of litigation... ...the most favorable and cost-effective resolutions in conformance with the most current legal precedent and ethical considerations... ...ability to forensically analyze medical records and varied technical...MedicalLegalClaimsWork at officeLocal areaRemote work1 day per week
$50k - $75k
Workers’ Compensation Claims Adjuster II - California | 100% Remote... ...compensation claims with moderate medical and indemnity benefit exposure... ...disabilities and related costs, as well as judgment of extent... ...exposure. Reviews and analyzes legal exposures. Collaborates with...MedicalLegalClaimsRemote workWork from home$72.7k
...Condition Category (HCC) coding, medical coding, clinical terminology... ...and external entities; leads activities with provider entities... ...records, compares audit results to claims, and thoroughly reviews all in... ...adheres to the ethical and legal standards and behavioral expectations...MedicalLegalClaimsRemote jobContract workFor contractorsWork at officeLocal areaFlexible hours$107.6k - $170.3k
...Information Technology, Customer Operations, and Legal/Claims. The position serves as a clearinghouse... ...to comprehensive benefits including medical, dental, vision, parental leave, family... ...both MAST and Union. Proven success at leading teams and effectively handling multiple...MedicalLegalClaimsFor contractorsLocal areaRemote workFlexible hours$174k - $179k
...and/or property damage claims during all phases of litigation... ...the most favorable and cost‑effective resolutions... ...with the most current legal precedent and ethical... ...forensically analyze medical records and varied... ...education. Discrepancies may lead to dismissal. OTHER...MedicalLegalClaimsWork at officeLocal area- ...Product Leader For Banking As A Service Platform Lead is a fintech building banking infrastructure... ..., product, design, and legal teams operate. We are... ...geographic location, and role Medical, Dental, Vision, Life, 40... ...reflects the cost of labor across several US...MedicalLegalFlexible hoursShift work
- ...firm is seeking a Bilingual (English/Spanish) Legal Assistant to become a part of our team! You will... ...Communicate with insurance companies to resolve various claim issues Communicate with courts regarding cases Obtain medical reports from various medical facilities...MedicalLegalClaims
$76.21k - $125.76k
ProAssurance is a leading specialty insurer specializing in... ..., products liability for medical technology and life sciences, legal professional liability,... ...compensation insurance. This remote Claims Specialist position is... ...and manage total claims cost. Ensure proper file...MedicalLegalClaimsWork at officeRemote work- ...AI Work with Security, Legal, and Compliance to meet privacy... ...such as: Time saved Cost reduction Increased speed... ...compensation, fully paid medical, dental, and vision, and a 4%... ...fraudulent individuals falsely claiming to represent OP Labs in recruitment...MedicalLegalClaimsWork at officeRemote work
$76.21k - $125.76k
Claims Specialist - Medical Professional Liability page is loaded## Claims Specialist... ...and life sciences, legal professional liability, and... ...insurance. We are an industry-leading specialty insurer, with job... ...reserves, and manage total claims cost. Ensure proper file...MedicalLegalClaimsWork at officeRemote work- Claim Specialist needed to combat rising healthcare costs and empower health plans! The Phia Group is a service-oriented... .... Until recently, surprise medical bills were a leading cause of financial distress... ...Work with The Phia Group’s legal department to ensure escalation...MedicalLegalClaimsWork at office
- ...Expert to join its Western Claims Service Center team. As... ...and determining repair costs. Strong knowledge of... ...Us Chubb is a world leader in insurance. With operations... ...physical disability, medical condition, genetic... ...Business Unit United States Legal Employer ACE American...MedicalLegalClaimsFull timeTemporary workLocal area
$60 - $70 per hour
...Global: PTR Global is a leading provider of information... ...role, as well as the cost of labor in the market;... ...to benefits, including medical, dental, vision, and 40... ..., email, or phone call claiming to be from PTR Global do... ...any concerns, please email us at legal@pinnacle1.comMedicalLegalClaimsFull timeContract work- The Drilling Section Leader has responsibility for the... .... Ability to claim and accept ownership of... ...to control drilling rig costs, maintaining each category... ...accommodation, hospital upkeep and medical care, suitable drinking... ...Developing Yourself, Leading Your Team, Driving the...MedicalClaimsTraineeshipWork at officeLocal areaImmediate startRelocation
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