Medical Director, Claims & Coverage Optimization
ISHE
Optum, a part of UnitedHealth Group, seeks a Medical Director to provide physician support for Enterprise Clinical Services. You will lead clinical reviews for benefit determinations, collaborate with leadership to implement processes, and ensure high-quality, cost-effective care for members. The role involves peer-to-peer discussions with providers, clinical rounds participation, and clear communication of medical policies across networks. #J-18808-Ljbffr ISHE
$248.5k - $373k
...- $373,000/yearJob Area: Medical & Clinical OperationsCompany... ...help us advance health optimization on a global scale. Join us... ...expectations as we deliver clinical coverage and medical claims reviews. Our role is to... ...care costs.The Medical Director provides physician support...ClaimsMinimum wageFull timeWork experience placementLocal areaRemote work- ...associate or partner to join its Insurance Coverage Practice. The ideal candidate will have... ...regarding issues such as bad faith claims, DISCLAIMERS of coverage, coverage allocation... ...Brisbois offers a range of benefits including medical, dental, vision, life insurance, and 401k...ClaimsWork at office
- UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services. The role focuses on clinical knowledge applied to benefit coverage determinations and cost-efficient, high-quality care. You will work with network and non-network...Claims
- UnitedHealth Group's Optum division seeks a Medical Director to provide physician guidance to Enterprise Clinical Services, leading clinical coverage determinations and utilization management with emphasis on quality and cost effectiveness. You will collaborate with network...Claims
- Optum, a global health care company, is seeking a Medical Director to provide physician leadership for Enterprise Clinical Services. You will guide clinical coverage determinations, collaborate with network and non-network physicians, and help drive cost-effective, high...ClaimsRemote job
$165k - $180k
...coordinating counsel. About the Role Our client is seeking an Insurance Coverage Associate with at least 3 years of law firm litigation... ...recognized leader in the area of insurance coverage and claims handling complex matters for clients around the world. This isn...ClaimsContract workWork at officeImmediate start- ...complex, disputed, or escalated medical review determinations across... ...defensible under Medicare coverage policy. Actively engage with... ...utilization review, or healthcare claims processing, including... ...Qualifications Prior Contractor Medical Director or Medical Director...ClaimsFull timeFor contractorsWork at officeLocal areaRemote work
- Optum, a part of UnitedHealth Group, is seeking a Medical Director to provide physician support for Enterprise Clinical Services, shaping benefit coverage determinations and quality improvement initiatives. The role involves collaborating with network and non-network physicians...ClaimsRemote job
$105k - $160k
...Insurance Coverage Litigation Attorney Our client's Atlanta office currently seeks an experienced Insurance Coverage Litigation Attorney... ...E&O & D&O) ~ Experience in both third-party and first-party claims ~ Superior analytical skills ~ Excellent written and oral...ClaimsWork at office- ...Atlanta office, specializing in high-stakes property insurance coverage disputes. Ideal candidates will possess a minimum of seven years... ...member of the Georgia Bar. Responsibilities include evaluating claims, drafting opinions, and participating in legal proceedings....ClaimsWork at office
- ...senior associate or partner for its Insurance Coverage Practice. Candidates should have 7-10... ...insurance coverage, including bad faith claims and policy interpretation. Key responsibilities... ...compensation and benefits, including medical, dental, and 401k with employer match. #J...Claims
$112.7k - $193.2k
...as you help us advance health optimization on a global scale. Join us to... ...for each member Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical...ClaimsRemote jobMinimum wageFull timeWork experience placementLocal area$200k
A prominent law firm based in Georgia is seeking an experienced Insurance Coverage Attorney to join their remote team. You will manage complex claims across multiple jurisdictions, provide litigation support, and work with seasoned attorneys in a dynamic environment. The...ClaimsRemote job$63.8k - $105.4k
...Auto Physical Damage Claims Estimator Taking care of our customers, our communities... ...basic and some moderate physical damage coverages as it relates to damage assessment. This... ...professionals on claim damages to achieve optimal outcomes. Delivers consistent service...ClaimsTemporary work$175k
This opportunity sits within a Chambers-ranked insurance coverage practice that has built a national reputation handling some of the market... ...coverage litigation Defective product and catastrophic loss claims Complex property & casualty coverage disputes Multi-layer and...Claims- The Medical Claims & Billing Coordinator will support day-to-day insurance, billing, coding, and administrative processes within a healthcare... ..., coding, and claim-processing issues Verify insurance coverage and maintain current patient, payer, and billing information...ClaimsWork at office
$97k - $189k
...limits, to manage the most complex, highest exposure commercial claims for a specialized line of business. Responsibilities include... ...manage and oversee all aspects of the claim handling, including coverage determinations, investigations, and resolution strategies which...ClaimsFull timeWork experience placementWork at officeLocal areaFlexible hoursShift work- ...office File patient insurance claims and follow up on outstanding... ...benefits and explanation of coverage Post insurance and patient payments... ...Heartland Dental systems to optimize office potential What You'll... ...of experience in a dental or medical setting 1+ years of...ClaimsDaily paidFull timeWork at officeLocal area
- Optum seeks a Medical Director to provide physician support for Enterprise Clinical Services, focusing on post-service benefit determinations and medical necessity decisions. You will lead clinical reviews, collaborate with hospital networks, and contribute to cost-effective...ClaimsRemote job
$200k
Insurance Coverage Attorney | Up to $200k Base | GA (Remote) We Are Legal Revolution provided pay range This range is provided by We Are... ...complex insurance coverage matters involving substantial claims across a wide range of industries, providing exposure to high-profile...ClaimsRemote jobFull time$130k - $150k
...Embrace innovation. Experience . Real Chemistry is looking for a Medical Director, Publications to join our growing team! The Medical Director... ...information or make payments to any unverified sources claiming to be connected to Real Chemistry. We are working to stop these...ClaimsWork experience placementWork at officeLocal areaRemote work2 days per week- ...RCM Training & Process Optimization Specialist RethinkFirst was founded in 2007 with a mission to provide scalable, evidence-based autism... ..., Accounts Receivable, Payment Posting, Cash Reconciliation, Claims Management, or related revenue cycle operations. Ability to...ClaimsRemote workWorldwide
- Optum is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on post-service benefit determinations and medical necessity. This remote role involves collaboration with network and non-network physicians to ensure cost-effective...ClaimsRemote job
- BCG Attorney Search seeks an attorney to join its insurance coverage practice in Atlanta, GA, handling complex coverage matters for insurers in commercial litigation. The candidate should be admitted in a relevant jurisdiction and have experience in insurance coverage...
- ...carriers reinvent Underwriting and Claims through process redesign,... ...opportunities to reimagine and optimize outcomes..Lead end-to-end business... ...suite of benefits including medical, dental, vision, life, and long-term disability coverage, a 401(k) plan, bonus opportunities...ClaimsFull timeLive inWork at officeLocal area
- ...value stream from quoting through claims — will capture significant five... ...suite of benefits including medical, dental, vision, life, and long-term disability coverage, a 401(k) plan, bonus opportunities... ...build their digital core, optimize their operations, accelerate revenue...ClaimsFull timeLive inWork at officeLocal areaShift work
- ...Atlanta office focuses on sophisticated and high-stakes insurance coverage disputes for a diverse client base in the U.S. and abroad. This... .... Responsibilities Evaluate first‑party property insurance claims Draft coverage opinions Prepare pleadings and discovery materials...Work at office2 days per week
$120k - $150k
...and protection for the digital age. With 98% of cyber insurance claims in the past five years coming from small and mid-size... ...to chart the best course for resolving cyber incidentsEvaluate coverage for claims and draft coverage letters.Build strong relationships...Claims- ...risk division of AXA, is seeking a Senior Claims Specialist for TPA Liability to manage... .... You will coordinate with TPAs, review coverage, and guide complex claim resolution while... ...across coverage, investigation and reserving to optimize outcomes #J-18808-Ljbffr...Claims
- ...matters, drafting pleadings and memos, and representing clients in coverage disputes. Ideal candidates have exposure to policyholder... ...competitive compensation and a comprehensive benefits package, with medical, dental, vision, life, disability, FSA, 401(k), PTO, #J-18808-...
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