- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …are aligned with corporate scientific objectives, compliant with regulatory and legal standards, and executed with excellence to advance Otsuka's commitment to ... Lead and requires strong cross-functional collaboration with Medical Affairs, Legal , Compliance, Finance, and external partners. **Job Description** **Key… more
- Elevance Health (Miami, FL)
- …with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable ... conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to nursing… more
- The Hartford (Lake Mary, FL)
- …+ Communicate with the court, witnesses, opposing counsel, and co-counsel with professional diplomacy and discretion. + Participate in claims file reviews. ... Staff Attorney will handle the following key responsibilities: + Analyze complex legal factual issues while conducting extensive and well-reasoned legal … more
- MyFlorida (Miami, FL)
- …District 6 Chief Counsel's office This position will be responsible for providing legal counsel and representation of the Department in all phases of the acquisition ... conveyance documents. Responsible for representation in defense of the Department in claims of inverse condemnation, as assigned. The Difference You Will Make:… more
- MyFlorida (Tallahassee, FL)
- …vendors and participants in federal programs. This includes advising on key legal processes like sanctions, financial claims disallowances, and administrative ... required for the position:Admission to the Florida Bar and professional experience in the practice of law, legal... professional experience in the practice of law, legal research, or in administrative or judicial hearings Qualifications:… more
- Sedgwick (Tallahassee, FL)
- …Services & Insurance Executive General Adjuster **PRIMARY PURPOSE** : To investigate claims internationally of any size or complexity, against insurance or other ... of findings and negotiates settlement with claimant. + Recommends litigation by legal department when settlement cannot be negotiated. + Attends litigation hearings.… more
- Molina Healthcare (FL)
- …enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims ... of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of Local, State… more
- Sedgwick (Jacksonville, FL)
- …Adjuster - Southeast Region **PRIMARY PURPOSE** **:** To investigate losses or claims internationally on any size National Account (Maintaining a minimum of five ... of findings and negotiates settlement with claimant. + Recommends litigation by legal department when settlement cannot be negotiated. + Attends litigation hearings.… more
- Cleveland Clinic (Weston, FL)
- …terms, legal issues and contract analysis + Experience with claims payment methodologies and operations + Working knowledge of contemporary healthcare policies, ... of international and emerging market payer contracts, overseeing all administrative, legal , operational and financial aspects. In this role, you will evaluate… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …FAQs, and global core content. + Ensure all content complies with regulatory, legal , and medical standards, and is aligned with product strategy and scientific ... messaging. + Collaborate cross-functionally with Medical Affairs, Regulatory, Legal , and Commercial teams to ensure consistency and accuracy of medical… more