32 legal jobs found in Syracuse, NY

Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Legal Compensation Overview The hourly salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual hourly rate for this position will be determined by a number of factors, including the scope, complexity...

The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a Remote role.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Expectation that Senior Claims Specialist maintain independent NY adjuster license as a casualty or general adjuster.  Receives claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the...

The Licensed Practical Nurse-Utilization Review gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel. This is a remote role.  This role position requires an LPN or LVN.    ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identifies the necessity of the review process and communicates any specific issues of concern to the appropriate claims staff/customer Collects data and analyzes information to make decisions regarding certification or denial of treatment Documents all work in the appropriate manner Promotes utilization review services with stakeholders Additional duties as assigned   KNOWLEDGE & SKILLS:  Must have a thorough knowledge of both CPT and ICD coding Ability to interface with claims staff, attorneys,...

The Permanent Northeast Floater provides experienced claims support across New York and New England, assuming temporary responsibility for diverse caseloads and clients as business needs arise.  This role manages complex and high-visibility workers’ compensation claims within delegated authority, determines benefits due, works closely with case managers and attorneys, partners with subrogation and negotiates settlements.  The position ensures customer service requirements are met while achieving optimal claim outcomes, supporting both client expectations and the goals of the CorVel claims department. This is a remote role. The candidate selected for this role will be a permanent floater and will temporarily handle various caseloads in NY and New England as need arises. Must be licensed/experienced in NY and willing to get licensed in all New England states (CT, RI, NH, VT and/or ME)   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives assigned claims, confirms...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is a remote role.    ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as...

The Professional Review Supervisor is responsible for the supervision of all operations within their designated department. This position functions as a member of the Bill Review Department leadership team, ensuring optimum team performance by providing exemplary support and assistance to achieve the organizational goals of excellent customer service of the bill review department and of CorVel. This is a remote role.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Directs a team of employees in their day-to-day operations and the quality of services provided, focusing on production, timeliness and quality bill review performance Establishes employee performance goals and follow-up to ensure employees are achieving goals, providing encouragement, training and counseling as needed Evaluates and maintains appropriate staffing levels to ensure all work product is completed within internal and external customer turn-around time expectations Has ongoing responsibility for...

The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care.   This is a remote role.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and/or direct reporting manager   Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Utilize clinical and/or technical expertise to address the provision of medical care and identify inappropriate billing practices and errors, such as: duplicate billing, unbundling of charges, services not rendered, mathematical and data entry errors, undocumented services, reusable instrumentation, unused services and supplies, unrelated and/or separated charges, quantity and time...

The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and forms completion in addition to answering incoming telephone calls, supporting the goals of the Utilization Review / Case Management department, and of CorVel.  This is a remote role.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Takes calls relating to precertification requests Verifies that all patient, provider and facility information entered in system is accurate and up to date Enters notes and service requests in CareMC system Communicates with stakeholders in a timely and professional manner Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to handle multiple priorities in a high-volume, fast-paced, team-oriented environment Excellent written and verbal communication skills Ability to meet designated deadlines Computer proficiency and technical aptitude with...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote role.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as...

The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a remote role.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned   KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient in Microsoft Office applications Technical...

The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay; supporting the goals of the Case Management department, and of CorVel. This is a remote role.    ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Identifies the necessity of the review process and communicates any specific issues of concern to the appropriate claims staff/customer. Collects data and analyzes information to make decisions regarding certification or denial of treatment. Documenting all work in the appropriate manner. Requires regular and consistent attendance. Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP). Additional duties as required.   KNOWLEDGE & SKILLS:  Must have a thorough knowledge of both CPT and...

The Licensed Practical Nurse-Utilization Review gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel. This is a remote role.    ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identifies the necessity of the review process and communicates any specific issues of concern to the appropriate claims staff/customer Collects data and analyzes information to make decisions regarding certification or denial of treatment Documents all work in the appropriate manner Promotes utilization review services with stakeholders Additional duties as assigned   KNOWLEDGE & SKILLS:  Must have a thorough knowledge of both CPT and ICD coding Ability to interface with claims staff, attorneys, physicians and their representatives, and...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This role can be performed as hybrid or remote.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex...

The Administrative Assistant performs diverse administrative responsibilities for various levels of staff within the company. This position coordinates various projects and prepares reports and information which may be of a highly confidential and critical nature, supporting the goals of local management, and of CorVel. This is an On-Site role.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Answers telephones. Handles inquiries appropriately May open, read, prioritize, route and distribute incoming mail or other materials May coordinate and maintain scheduling and event calendars, including travel dates and arrangements, appointments with customers, meetings and conference calls Organizes and maintains document storage May create and prepare presentations, memos, reports, correspondence and miscellaneous projects May schedule travel, meetings and other events, along with monitoring calendars and room reservations May assist in basic accounting functions...

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Northern NJ and NYC area. Work from home, and on the road.  As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and their families.  Your responsibilities include working closely with injured workers to facilitate their recovery. You will work collaboratively with the patient, their family, medical providers, members of our team, and others.  This is a heavy local travel role responsible for working with a caseload of workers compensation injured workers within a defined jurisdiction.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides Medical Case Management to individuals through in person and telephonic communications with the patient, physician, other health care providers, employer and others. Utilizes their medical and nursing knowledge to discuss the current treatment plan...

Assists providers via phone and email with basic to complex bill review questions and requests. Documents bill review errors for tracking and trending to improve team error rate. Acts as a positive and professional representative of our CorVel family; ensures compliance with company best practice standards; ensure consistent, timely delivery of our quality services. This is a hybrid role reporting to our Syracuse, NY office. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate clearly and professionally with callers and via email. Maneuver in the bill review application to obtain accurate information for the callers. Understand CorVel EORs as well as client-specific nuances. Answer basic to complex State WC fee schedule and/or billing questions on processed medical bills covering regular as well as facility bill types Understand and be able to properly explain provider contracted rates, carve-outs and special LOAs applied to medical bills Requires regular and...

We’re thrilled that you are interested in joining us here at the Amynta Group! As a member of Oryx Insurance Brokerage, Inc claims team, utilize knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex construction nature in order to achieve appropriate outcomes. In this position you will administer and resolve Workers Compensation claims in a timely manner in accordance with legal statues, policy provisions and carrier guidelines. Responsibilities: Promptly investigate all assigned claims with minimal supervision, including those of a more complex Construction nature. Determine coverage, compensability, potential for subrogation recovery, and other offsets  (when applicable). Alert Supervisor and carriers Special Investigations Unit to potentially suspect claims. Ensure timely denial or payment of benefits in accordance with jurisdictional requirements. Establish appropriate reserves with documented...

A&H GROUP Regional UW A&H Regional UW Head Responsibilities 1.           Loss Ratio:  Maintain it at or below agreed upon levels. Portfolio Analysis:  Control and segment our business into Product P&Ls. Business retention also need to be monitored. Auditing:  For compliance, correctness, etc., use of underwriting authorities delegated locally, rating, wordings, file documentation, renewal underwriting, product development process, peer reviews, etc. Audits must be performed every 18-24 months or sooner and written reports sent to UW Regional Office for final review. Product Development:  Review and approve work done by others or perform work yourself.  All new products or major product changes must be approved by Regional Underwriting Manager, Regional Actuarial and Regional Legal as required. The Product Development process must be followed as appropriate. Case Underwriting:  Review/approve quotes on large and/or unusual market opportunities. Group Business....

The Fraud Investigator is responsible for conducting investigations and reporting suspected instances of insurance fraud. The Fraud Investigator reviews and researches evidence and documents to analyze the overall fact pattern of claim and synthesis data into professional reports with recommendations. Duties & Responsibilities: Conduct investigations in accordance with company, SIU, statutory, regulatory, and other legal guidelines. Identify leads and potential investigations from data, databases, and/or spreadsheets. Give regular, timely, and accurate written reports to the referring party in accordance with New York State regulation and company policies. Conduct interviews and take recorded or written statements. Verify receipts, complete activity checks, and other investigative processes with SIU resource materials such as cameras, computers, and recorders. Maintain chronological case order. Report all suspected instances of insurance fraud in accordance...

The Company      At Utica National Insurance Group, our 1,300 employees nationwide live our corporate promise every day: to make people feel secure, appreciated, and respected. We are an “A” rated, $1.7B award-winning, nationally recognized property & casualty insurance carrier. Headquartered in Central New York, we operate across the Eastern half of the United States, with major office locations in New Hartford, New York and Charlotte, and regional offices in Boston, New York City, Atlanta, Dallas, Columbus, Richmond, and Chicago. Job Summary Do you have a passion for numbers, risk analysis, and innovative problem-solving? As an Actuarial Analyst on our Personal Lines team, you’ll leverage standard ratemaking techniques, support rate filings, and learn advanced actuarial methods to help shape our pricing strategy. This role offers a clear path for growth through Casualty Actuarial Society exams and hands-on training, making it an ideal opportunity for...