Review and adjudicate medical claims to ensure accurate coding and reimbursement in compliance with payer requirements. Verify patient eligibility and provider credentials while collaborating with stakeholders to resolve claim discrepancies.
Remote Legal Jobs (3,626)
Job category = Legal
Responsible for the preparation and oversight of regulatory compliance requirements for IT and Financial Shared Services. This includes managing forward pricing rate submissions, quarterly cost monitoring reports to DCMA, and leading responses to DCAA audits.
The Contract Specialist oversees procurement processes and ensures strict compliance with federal and GSA regulations. Key duties include preparing solicitation documents, conducting cost analysis, and managing the full lifecycle of contract administration and closeout.
Assist house counsel with pre-trial tasks, including drafting motions, responses, and other legal documents. Conduct research, gather information for claim cases, and prepare cases for trial by assembling exhibits and trial books.
Assist house counsel with pre-trial tasks, including drafting motions, responses, and other legal documents. Conduct research, gather information for claim cases, and prepare cases for trial including exhibits and trial books.
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The VP, Chief Compliance Officer will develop and oversee the company's compliance and privacy programs in accordance with DOJ and HHS OIG guidelines. This role involves leading compliance teams, managing risk assessments, and serving as a strategic advisor to the Executive Leadership Team and Board of Directors.
Manage claims and lawsuits brought against policyholders by interpreting coverage and overseeing outside legal counsel. Resolve cases through settlement, dismissal, or trial while managing litigation costs and reserves.
Accident Benefits Claims Representative - lll
Portage Mutual Careers Centre
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Full Time
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1 Week Ago
Portage Mutual Careers Centre
Investigate, evaluate, and resolve complex automobile accident benefit claims by analyzing medical records and financial losses. Mentor junior team members and collaborate with stakeholders to ensure fair and timely claim outcomes.
The paralegal will focus on defending a major client in wage and hour individual arbitrations. Key duties include project administration, managing discovery, and using automation to draft motions and witness outlines.
Employment Litigation Attorney (Remote - California Licensed)
Kaufman Dolowich LLP
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Full Time
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1 Week Ago
Kaufman Dolowich LLP
Independently manage all phases of employment litigation from inception through resolution, including drafting pleadings and conducting depositions. Provide strategic legal counsel to employers on workplace compliance, risk management, and dispute resolution.
The Conflicts Attorney is responsible for reviewing and analyzing complex conflict reports for new business intake and lateral hires. They provide detailed advice to partners, draft conflict waivers, and implement ethical walls to manage firm risk.
Evaluate and process specialty claims to determine payment or denial based on plan provisions and medical policies. Manage coordination of benefits, research medical codes, and handle correspondence with providers and participants.
The Compliance Specialist is responsible for developing and monitoring programs to ensure adherence to regulatory requirements and internal policies regarding client information security. This includes conducting audits, updating policies based on regulatory changes, and providing compliance training to employees.
Intellectual Property (IP) Counsel
Genesis Molecular AI
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Full Time
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1 Week Ago
Genesis Molecular AI
Build and protect the company's IP portfolio spanning AI platforms and drug discovery programs, including patent strategy and prosecution. Additionally, negotiate commercial agreements and provide legal guidance on operational, regulatory, and compliance matters.
Drive the development of a new end-to-end operational process for commercial title transactions. Manage all technical aspects of transactions from underwriting to post-close while utilizing data for process improvements.
PAHO Consultant - Roster - Band B - Strengthening National Regulatory Systems for Medicines and Other Health Technologies in the Region of the Americas
Pan American Health Organization
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Full Time
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1 Week Ago
Pan American Health Organization
Provide technical guidance to national regulatory authorities to strengthen regulatory frameworks for medicines and health technologies. Support the implementation of the WHO Global Benchmarking Tool and facilitate the development of Institutional Development Plans.
Provide legal advisory services for the Transportation and Shipping Segment, focusing on reviewing and negotiating a wide range of commercial and technology contracts. Manage corporate governance, legal entity issues, and the implementation of corporate compliance policies.
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Provide legal advisory services and negotiate a wide range of commercial contracts for the Transportation and Shipping Segment. Manage legal entity governance and develop corporate compliance policies and standard form agreements.
The Claims Examiner is responsible for managing third-party general liability losses from inception to closure in a paperless environment. Key duties include analyzing policy language, setting reserves, and coordinating with outside vendors and legal counsel.
Provides underwriting support, counsel, and authorization for the issuance of real estate title insurance commitments and policies. Responsible for establishing underwriting standards and guiding company personnel in real estate settlement services.
Manage and support provider contracts across various lines of business, including drafting agreements, amendments, and negotiating Letters of Agreement. Act as a liaison between providers and internal departments to resolve operational issues and implement contract terms in systems like Epic.
Lead complex commercial negotiations and data partnership agreements while providing legal guidance on privacy, AI, and product development. Support broader legal functions including corporate governance, employment matters, and the implementation of legal technology workflows.
Provide operational leadership for a Philippines-based claims adjudication team to ensure quality, throughput, and reporting accuracy. Serve as the senior single point of contact for the client, translating requirements into executable procedures and managing escalations.
The Hospital Regulatory Manager leads regulatory readiness efforts across all markets to ensure compliance with federal, state, and accreditation standards. This includes coordinating mock surveys, managing documentation, and partnering with leadership to mitigate risks and improve patient safety.
Design and scale the operational infrastructure for Legal and Compliance functions, focusing on systems, workflows, and process optimization. Lead the integration of AI-driven capabilities and automation to enhance the efficiency and auditability of legal services.
Technical Resource and Regulatory Specialist
Barry-Wehmiller
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Full Time
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1 Week Ago
Barry-Wehmiller
Serve as the primary technical contact for the engineering community to promote products and obtain regulatory approvals across the US and Canada. Monitor regulatory changes and collaborate with sales teams to provide technical justification and support for customers.
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Direct the delivery of workers' compensation legislative and regulatory information and training to ensure operational compliance. Serve as a subject matter expert for industry stakeholders and provide technical consultation to clients and internal departments.
Claims - Eligibility Specialist 2, Claims
Wellcove/CHCS-Services
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Full Time
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1 Week Ago
Wellcove/CHCS-Services
Responsible for reviewing Long-Term Care insurance policy benefit eligibility and determining approvals or denials based on company and federal guidelines. This includes interpreting policy provisions, requesting medical records, and communicating determinations to claimants.
Act as the primary legal point person for Lending Partnerships, providing strategic advice to mitigate risk and drive business growth. Review, draft, and negotiate a wide variety of complex commercial agreements including SaaS, loan sale, and servicing agreements.
Draft and negotiate a wide variety of commercial agreements, including GTM, procurement, and product partnerships. Advise business partners on commercial strategies to accelerate revenue while mitigating legal and business risks.
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