2 jobs found

We are seeking a bilingual Claims Consultant who will cover Hospital, Physicians & Surgeons claims in Puerto Rico and the Southeast region. The ideal candidate would be located within the Southeast United States.  In this role, you will… Confirm coverage and then manage claims and suits brought against policyholders. Interpret, analyze, and resolve coverage issues. Select legal counsel. Manage the litigation with outside counsel. Manage litigation costs, both fees and expenses. Post reserves for both loss and ALE. Resolve cases, via settlement, dismissal or trial. Negotiate. Provide service to insureds, assist where possible in sales and retention efforts of sales force. Perform other activities required of a front line claims person. We are looking for candidates with… Excellent written and verbal communication skills in both Spanish and English languages. Minimum of five years of claim experience, preferably...

PURPOSE:  The Litigation General Counsel is responsible for (1) evaluating and analyzing litigation brought by and against CareFirst, Inc., its subsidiaries, and affiliates (“the Company”); (2) effectively resolving disputes prior to litigation where advantageous to the Company; (3) directly providing effective representation for the Company in appropriate federal, state and alternative venues; (4) overseeing and managing litigation conducted with use of external counsel; (5) overseeing the implementation of effective litigation strategies and achieving strong results and litigation outcomes; (6) effectively communicating with business partners and executive teams regarding litigation and litigation risks; (7) managing internal and external discovery and effectively using and promoting litigation technology and technical capabilities; and (8) advising on litigation related risks. ESSENTIAL FUNCTIONS: Direct Representation - Directly represents the Company in litigation...